Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $6,025.60 / $18,620.87	Facility		$281.84	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $537.03	Professional		$128.82	$186.21	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $512.86 / $912.01	Facility		$331.13	$512.86	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $446.68	Professional		$181.97	$239.88	$446.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $331.13 / $1,122.02	Facility		$213.80	$331.13	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $323.59 / $467.74	Professional		$213.80	$323.59	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $288.40 / $363.08	Facility		$251.19	$288.40	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $208.93	Facility		$204.17	$204.17	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $346.74 / $446.68	Professional		$208.93	$346.74	$446.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,137.96	Facility		$776.25	$1,122.02	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $281.84 / $389.05	Professional		$177.83	$281.84	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,513.56 / $3,235.94	Facility		$501.19	$1,513.56	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $251.19 / $436.52	Professional		$162.18	$251.19	$436.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $173.78 / $288.40	Professional		$39.81	$173.78	$288.40