Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $602.56 / $616.60	Professional		$575.44	$602.56	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $1,230.27	Facility		$616.60	$616.60	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
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 $44.67 / $50.12 / $64.57	Professional		$44.67	$50.12	$64.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $616.60	Facility		$602.56	$602.56	$616.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
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 / $724.44	Professional		$125.89	$151.36	$724.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04