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 $79.43 / $83.18 / $85.11	Professional		$79.43	$83.18	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $169.82	Facility		$85.11	$85.11	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $478.63 / $645.65	Facility		$346.74	$478.63	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $5.25 / $5.25	Professional		$5.25	$5.25	$5.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $75.86	Professional		$30.20	$50.12	$75.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $85.11	Facility		$83.18	$83.18	$85.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
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 / $162.18	Professional		$125.89	$125.89	$162.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04