Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $1,000.00 / $17,782.79	Facility		$288.40	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $389.05	Professional		$128.82	$165.96	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $467.74 / $562.34	Facility		$302.00	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $257.04 / $489.78	Professional		$141.25	$257.04	$489.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $223.87 / $389.05	Facility		$138.04	$223.87	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $234.42 / $389.05	Professional		$138.04	$234.42	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $83.18	Professional		$32.36	$33.11	$83.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $275.42 / $316.23	Facility		$194.98	$275.42	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $213.80	Facility		$199.53	$199.53	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $323.59 / $436.52	Professional		$208.93	$323.59	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $660.69 / $1,288.25	Facility		$436.52	$660.69	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $288.40 / $389.05	Professional		$199.53	$288.40	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $912.01 / $1,949.84	Facility		$416.87	$912.01	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $398.11	Professional		$158.49	$218.78	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $331.13	Professional		$173.78	$213.80	$331.13