Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $1,000.00 / $17,782.79	Facility		$194.98	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $147.91 / $354.81	Professional		$85.11	$147.91	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $204.17 / $389.05	Professional		$123.03	$204.17	$389.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $229.09 / $389.05	Facility		$144.54	$229.09	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $229.09 / $380.19	Professional		$144.54	$229.09	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $281.84 / $302.00	Facility		$190.55	$281.84	$302.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $199.53 / $208.93	Facility		$112.20	$199.53	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $234.42 / $371.54	Professional		$131.83	$234.42	$371.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $562.34 / $1,096.48	Facility		$371.54	$562.34	$1,096.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $302.00	Professional		$125.89	$199.53	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $741.31 / $1,862.09	Facility		$501.19	$741.31	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $371.54	Professional		$120.23	$190.55	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $151.36 / $213.80	Professional		$83.18	$151.36	$213.80