Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $190.55	Facility		$79.43	$79.43	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $112.20	Professional		$53.70	$67.61	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $100.00	Professional		$85.11	$85.11	$100.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $177.83 / $354.81	Facility		$70.79	$177.83	$354.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $158.49 / $263.03	Professional		$70.79	$158.49	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $131.83	Professional		$75.86	$107.15	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $123.03 / $128.82	Facility		$120.23	$123.03	$128.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $97.72 / $97.72	Professional		$89.13	$97.72	$97.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $181.97 / $263.03	Facility		$107.15	$181.97	$263.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $134.90	Professional		$102.33	$102.33	$134.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $138.04	Professional		$107.15	$107.15	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $186.21 / $186.21	Facility		$74.13	$186.21	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $107.15	Professional		$53.70	$77.62	$107.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $331.13	Professional		$89.13	$107.15	$331.13