Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $295.12	Professional		$169.82	$218.78	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,071.52 / $1,778.28	Facility		$537.03	$1,071.52	$1,778.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $1,096.48 / $1,862.09	Facility		$380.19	$1,096.48	$1,862.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Professional		$933.25	$933.25	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $70.79	Professional		$30.20	$50.12	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $331.13 / $398.11	Facility		$234.42	$331.13	$398.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $275.42 / $275.42	Facility		$269.15	$275.42	$275.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $588.84	Professional		$275.42	$426.58	$588.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,096.48 / $2,089.30	Facility		$831.76	$1,096.48	$2,089.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $389.05 / $524.81	Professional		$275.42	$389.05	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,318.26 / $2,398.83	Facility		$933.25	$1,318.26	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $398.11 / $933.25	Professional		$316.23	$398.11	$933.25