Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $537.03	Facility		$223.87	$223.87	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $389.05	Professional		$107.15	$169.82	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $436.52	Professional		$407.38	$407.38	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $489.78 / $630.96	Facility		$218.78	$489.78	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $512.86 / $660.69	Professional		$223.87	$512.86	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $457.09 / $467.74	Facility		$380.19	$457.09	$467.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $457.09 / $660.69	Professional		$316.23	$457.09	$660.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $346.74 / $660.69	Facility		$288.40	$346.74	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $2.51 / $151.36 / $199.53	Facility		$2.51	$151.36	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $223.87 / $380.19	Professional		$147.91	$223.87	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00