Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $831.76 / $1,862.09	Facility		$173.78	$831.76	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $223.87	Professional		$112.20	$147.91	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $407.38 / $478.63	Facility		$190.55	$407.38	$478.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $186.21 / $851.14	Facility		$165.96	$186.21	$851.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $316.23	Professional		$147.91	$186.21	$316.23
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 $186.21 / $186.21 / $257.04	Facility		$186.21	$186.21	$257.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $323.59 / $549.54	Facility		$186.21	$323.59	$549.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $223.87	Professional		$165.96	$165.96	$223.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $275.42 / $489.78	Facility		$194.98	$275.42	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $165.96 / $208.93	Professional		$158.49	$165.96	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $223.87 / $223.87	Facility		$186.21	$223.87	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $208.93	Professional		$77.62	$77.62	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $186.21 / $331.13	Professional		$83.18	$186.21	$331.13