Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $1,230.27 / $2,754.23	Facility		$257.04	$1,230.27	$2,754.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $331.13	Professional		$162.18	$218.78	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $602.56 / $707.95	Facility		$288.40	$602.56	$707.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $275.42 / $1,258.93	Facility		$245.47	$275.42	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $467.74	Professional		$218.78	$275.42	$467.74
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 $275.42 / $275.42 / $389.05	Facility		$275.42	$275.42	$389.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $478.63 / $831.76	Facility		$275.42	$478.63	$831.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $331.13	Professional		$245.47	$245.47	$331.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $416.87 / $724.44	Facility		$288.40	$416.87	$724.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $245.47 / $309.03	Professional		$234.42	$245.47	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $331.13 / $331.13	Facility		$275.42	$331.13	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $309.03	Professional		$114.82	$114.82	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $275.42 / $489.78	Professional		$123.03	$275.42	$489.78