Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $10,232.93 / $28,183.83	Facility		$64.57	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $57.54 / $72.44	Professional		$12.88	$57.54	$72.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $6,025.60	Facility		$6,025.60	$6,025.60	$6,025.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $6,165.95 / $19,054.61	Facility		$3,467.37	$6,165.95	$19,054.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $4,265.80 / $6,309.57	Professional		$2,818.38	$4,265.80	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $75.86	Professional		$33.11	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $125.89 / $4,265.80	Facility		$63.10	$125.89	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $144.54 / $389.05	Professional		$85.11	$144.54	$389.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $13,182.57 / $25,118.86	Facility		$8,511.38	$13,182.57	$25,118.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $158.49	Professional		$87.10	$112.20	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $16,218.10 / $26,302.68	Facility		$3,467.37	$16,218.10	$26,302.68
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $81.28 / $177.83	Professional		$37.15	$81.28	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33