Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $95.50	Professional		$58.88	$83.18	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,047.13 / $1,778.28	Facility		$346.74	$1,047.13	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
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 $125.89 / $181.97 / $186.21	Facility		$125.89	$181.97	$186.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $128.82	Facility		$117.49	$117.49	$128.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $275.42	Professional		$128.82	$190.55	$275.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,047.13 / $1,995.26	Facility		$794.33	$1,047.13	$1,995.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $245.47	Professional		$112.20	$158.49	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,288.25 / $2,344.23	Facility		$933.25	$1,288.25	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $223.87	Professional		$81.28	$97.72	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43