Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $144.54	Professional		$74.13	$102.33	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $204.17 / $323.59	Facility		$123.03	$204.17	$323.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $213.80 / $323.59	Professional		$131.83	$213.80	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $151.36	Professional		$32.36	$33.11	$151.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $158.49	Facility		$147.91	$147.91	$158.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $275.42 / $398.11	Facility		$186.21	$275.42	$398.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $147.91	Professional		$125.89	$125.89	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $169.82	Professional		$131.83	$131.83	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $123.03	Professional		$50.12	$64.57	$123.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $151.36 / $234.42	Professional		$131.83	$151.36	$234.42