Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $676.08 / $1,995.26	Facility		$141.25	$676.08	$1,995.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $208.93	Professional		$100.00	$131.83	$208.93
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 $158.49 / $199.53 / $316.23	Facility		$158.49	$199.53	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $338.84	Professional		$158.49	$199.53	$338.84
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 $177.83 / $218.78 / $346.74	Facility		$177.83	$218.78	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $309.03 / $446.68	Facility		$147.91	$309.03	$446.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $213.80	Professional		$134.90	$134.90	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $295.12 / $549.54	Facility		$208.93	$295.12	$549.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $223.87	Professional		$169.82	$177.83	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $239.88 / $239.88	Facility		$199.53	$239.88	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $190.55	Professional		$63.10	$69.18	$190.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $199.53 / $354.81	Professional		$89.13	$199.53	$354.81