Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $416.87 / $912.01	Facility		$85.11	$416.87	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $109.65	Professional		$60.26	$79.43	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $208.93 / $269.15	Facility		$95.50	$208.93	$269.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $426.58	Facility		$91.20	$91.20	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $91.20 / $154.88	Professional		$81.28	$91.20	$154.88
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 $83.18 / $100.00 / $162.18	Facility		$83.18	$100.00	$162.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $162.18 / $275.42	Facility		$91.20	$162.18	$275.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $109.65	Professional		$83.18	$83.18	$109.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $138.04 / $251.19	Facility		$95.50	$138.04	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $102.33	Professional		$77.62	$83.18	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $109.65 / $109.65	Facility		$91.20	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $47.86 / $109.65	Professional		$38.90	$47.86	$109.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $91.20 / $165.96	Professional		$41.69	$91.20	$165.96