Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $676.08 / $1,513.56	Facility		$141.25	$676.08	$1,513.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $181.97	Professional		$97.72	$123.03	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $331.13 / $389.05	Facility		$154.88	$331.13	$389.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $151.36 / $691.83	Facility		$134.90	$151.36	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $257.04	Professional		$120.23	$151.36	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $165.96 / $263.03	Facility		$134.90	$165.96	$263.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $263.03 / $446.68	Facility		$151.36	$263.03	$446.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $181.97	Professional		$134.90	$134.90	$181.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $223.87 / $416.87	Facility		$158.49	$223.87	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $169.82	Professional		$128.82	$134.90	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $169.82	Professional		$63.10	$63.10	$169.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $151.36 / $269.15	Professional		$67.61	$151.36	$269.15