Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $478.63 / $1,071.52	Facility		$100.00	$478.63	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $128.82	Professional		$70.79	$87.10	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $239.88 / $275.42	Facility		$112.20	$239.88	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $107.15 / $169.82	Facility		$85.11	$107.15	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $181.97	Professional		$85.11	$107.15	$181.97
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 $95.50 / $117.49 / $186.21	Facility		$95.50	$117.49	$186.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $186.21 / $323.59	Facility		$107.15	$186.21	$323.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $128.82	Professional		$95.50	$95.50	$128.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $162.18 / $295.12	Facility		$112.20	$162.18	$295.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $95.50 / $120.23	Professional		$91.20	$95.50	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $128.82 / $128.82	Facility		$107.15	$128.82	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $120.23	Professional		$44.67	$44.67	$120.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $107.15 / $190.55	Professional		$47.86	$107.15	$190.55