Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $3,981.07 / $18,620.87	Facility		$128.82	$3,981.07	$18,620.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $676.08 / $758.58	Facility		$630.96	$676.08	$758.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $147.91 / $245.47	Facility		$102.33	$147.91	$245.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $194.98 / $204.17	Facility		$151.36	$194.98	$204.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $138.04	Facility		$134.90	$134.90	$138.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $6,025.60	Facility		$4,786.30	$4,786.30	$6,025.60
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $549.54 / $5,754.40	Facility		$158.49	$549.54	$5,754.40