Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $501.19 / $870.96	Facility		$114.82	$501.19	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $229.09	Professional		$81.28	$107.15	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $269.15 / $316.23	Facility		$125.89	$269.15	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $123.03 / $562.34	Facility		$109.65	$123.03	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $208.93	Professional		$107.15	$123.03	$208.93
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 $109.65 / $134.90 / $213.80	Facility		$109.65	$134.90	$213.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $213.80 / $363.08	Facility		$123.03	$213.80	$363.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Professional		$109.65	$109.65	$147.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $181.97 / $338.84	Facility		$128.82	$181.97	$338.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $138.04	Professional		$104.71	$109.65	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $147.91 / $147.91	Facility		$123.03	$147.91	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $147.91	Professional		$51.29	$63.10	$147.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $123.03 / $218.78	Professional		$54.95	$123.03	$218.78