Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $707.95 / $1,548.82	Facility		$147.91	$707.95	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $186.21	Professional		$93.33	$125.89	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $346.74 / $407.38	Facility		$162.18	$346.74	$407.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $158.49 / $251.19	Facility		$125.89	$158.49	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $269.15	Professional		$125.89	$158.49	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $173.78 / $275.42	Facility		$141.25	$173.78	$275.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $275.42 / $467.74	Facility		$158.49	$275.42	$467.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $186.21	Professional		$141.25	$141.25	$186.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $234.42 / $426.58	Facility		$165.96	$234.42	$426.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $141.25 / $173.78	Professional		$131.83	$141.25	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $186.21 / $186.21	Facility		$158.49	$186.21	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $173.78	Professional		$66.07	$66.07	$173.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $158.49 / $281.84	Professional		$70.79	$158.49	$281.84