Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $524.81 / $17,782.79	Facility		$169.82	$524.81	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $288.40	Professional		$83.18	$120.23	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $213.80	Facility		$181.97	$181.97	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $173.78 / $354.81	Professional		$95.50	$173.78	$354.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $144.54 / $309.03	Facility		$95.50	$144.54	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $269.15	Professional		$95.50	$147.91	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $58.88	Professional		$32.36	$33.11	$58.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $213.80 / $251.19	Facility		$154.88	$213.80	$251.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $169.82	Facility		$162.18	$162.18	$169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $316.23	Professional		$125.89	$218.78	$316.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $4,365.16 / $8,317.64	Facility		$2,884.03	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $281.84	Professional		$117.49	$186.21	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $5,370.32 / $8,912.51	Facility		$1,122.02	$5,370.32	$8,912.51
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $151.36 / $295.12	Professional		$102.33	$151.36	$295.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $186.21	Professional		$85.11	$131.83	$186.21