Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $177.83	Professional		$75.86	$114.82	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $151.36 / $295.12	Facility		$102.33	$151.36	$295.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $295.12	Professional		$102.33	$154.88	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $138.04 / $151.36	Professional		$123.03	$138.04	$151.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $141.25	Facility		$138.04	$138.04	$141.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $154.88	Professional		$117.49	$117.49	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $158.49 / $158.49	Professional		$151.36	$158.49	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $60.26 / $114.82	Professional		$47.86	$60.26	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $141.25	Professional		$123.03	$123.03	$141.25