Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $229.09	Professional		$181.97	$181.97	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $363.08	Facility		$173.78	$173.78	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $194.98	Professional		$181.97	$181.97	$194.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $380.19 / $588.84	Facility		$229.09	$380.19	$588.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $478.63	Professional		$186.21	$331.13	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $75.86	Professional		$50.12	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $275.42	Facility		$181.97	$181.97	$275.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $416.87	Facility		$275.42	$275.42	$416.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $275.42 / $275.42	Professional		$208.93	$275.42	$275.42
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 / $141.25 / $501.19	Professional		$125.89	$141.25	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04