Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $741.31 / $1,621.81	Facility		$154.88	$741.31	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $194.98	Professional		$109.65	$141.25	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $380.19 / $478.63	Facility		$169.82	$380.19	$478.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $758.58	Facility		$162.18	$162.18	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $162.18 / $281.84	Professional		$144.54	$162.18	$281.84
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 $147.91 / $181.97 / $288.40	Facility		$147.91	$181.97	$288.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $288.40 / $489.78	Facility		$162.18	$288.40	$489.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $194.98	Professional		$147.91	$147.91	$194.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $245.47 / $446.68	Facility		$173.78	$245.47	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $147.91 / $181.97	Professional		$138.04	$147.91	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $194.98 / $194.98	Facility		$162.18	$194.98	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $85.11 / $194.98	Professional		$69.18	$85.11	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $162.18 / $295.12	Professional		$74.13	$162.18	$295.12