Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $162.18	Professional		$134.90	$134.90	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $134.90	Facility		$125.89	$125.89	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $138.04	Professional		$134.90	$134.90	$138.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $354.81 / $588.84	Facility		$263.03	$354.81	$588.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $316.23 / $407.38	Professional		$213.80	$316.23	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $75.86	Professional		$30.20	$60.26	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $138.04 / $204.17	Facility		$134.90	$138.04	$204.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $158.49	Professional		$144.54	$144.54	$158.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $131.83	Professional		$125.89	$125.89	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $134.90	Professional		$125.89	$125.89	$134.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04