Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $125.89 / $125.89	Facility		$79.43	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $97.72 / $128.82	Professional		$44.67	$97.72	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $144.54 / $245.47	Facility		$85.11	$144.54	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $245.47	Professional		$85.11	$141.25	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $186.21 / $190.55	Facility		$154.88	$186.21	$190.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $275.42	Professional		$128.82	$190.55	$275.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $245.47	Professional		$131.83	$181.97	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $245.47	Professional		$95.50	$138.04	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82