Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $416.87 / $426.58	Professional		$398.11	$416.87	$426.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $851.14	Facility		$426.58	$426.58	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $288.40 / $467.74	Facility		$169.82	$288.40	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $363.08	Professional		$165.96	$281.84	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $426.58	Facility		$416.87	$416.87	$426.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
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 / $151.36 / $501.19	Professional		$125.89	$151.36	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04