Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $169.82 / $234.42	Professional		$19.95	$169.82	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $302.00 / $457.09	Facility		$37.15	$302.00	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $295.12 / $446.68	Professional		$40.74	$295.12	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $32.36 / $64.57	Professional		$16.98	$32.36	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $194.98 / $199.53	Facility		$158.49	$194.98	$199.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $288.40	Facility		$239.88	$239.88	$288.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $645.65	Professional		$288.40	$416.87	$645.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $363.08 / $549.54	Professional		$257.04	$363.08	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $602.56	Professional		$173.78	$281.84	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $416.87	Professional		$218.78	$251.19	$416.87