Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $616.60	Facility		$263.03	$263.03	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $446.68	Professional		$173.78	$245.47	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Facility		$251.19	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $251.19	Professional		$194.98	$194.98	$251.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $478.63 / $933.25	Facility		$229.09	$478.63	$933.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $512.86 / $933.25	Professional		$257.04	$512.86	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $407.38 / $416.87	Professional		$60.26	$407.38	$416.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $407.38 / $537.03	Facility		$398.11	$407.38	$537.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $354.81 / $660.69	Facility		$338.84	$354.81	$660.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $446.68	Professional		$338.84	$338.84	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $457.09	Professional		$346.74	$346.74	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $3.24 / $204.17 / $269.15	Facility		$3.24	$204.17	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $389.05	Professional		$190.55	$269.15	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $616.60	Professional		$245.47	$288.40	$616.60