Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $6,456.54 / $20,892.96	Facility		$1,737.80	$6,456.54	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $95.50	Professional		$57.54	$79.43	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
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 $117.49 / $158.49 / $162.18	Facility		$117.49	$158.49	$162.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $229.09	Professional		$109.65	$162.18	$229.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $120.23 / $229.09	Facility		$100.00	$120.23	$229.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $154.88 / $204.17	Professional		$97.72	$154.88	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $89.13 / $213.80	Professional		$81.28	$89.13	$213.80