Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,000.00 / $17,782.79	Facility		$199.53	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $295.12	Professional		$95.50	$128.82	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $724.44	Facility		$416.87	$416.87	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $323.59	Professional		$128.82	$181.97	$323.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $223.87 / $288.40	Facility		$144.54	$223.87	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $229.09 / $288.40	Professional		$151.36	$229.09	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $67.61	Professional		$32.36	$33.11	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $223.87 / $239.88	Facility		$186.21	$223.87	$239.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $316.23	Professional		$147.91	$239.88	$316.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $724.44	Facility		$575.44	$575.44	$724.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $288.40	Professional		$138.04	$204.17	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $645.65 / $5,754.40	Facility		$141.25	$645.65	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $323.59	Professional		$131.83	$169.82	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $181.97	Professional		$95.50	$128.82	$181.97