Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $257.04 / $18,620.87	Facility		$114.82	$257.04	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $109.65 / $257.04	Professional		$58.88	$109.65	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $181.97	Facility		$109.65	$109.65	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $331.13	Professional		$95.50	$177.83	$331.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $158.49 / $457.09	Facility		$83.18	$158.49	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $281.84	Professional		$87.10	$151.36	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $38.90	Professional		$32.36	$33.11	$38.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $213.80 / $223.87	Facility		$144.54	$213.80	$223.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $288.40	Professional		$85.11	$154.88	$288.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $2,951.21	Facility		$1,148.15	$1,548.82	$2,951.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $154.88 / $269.15	Professional		$89.13	$154.88	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,995.26 / $4,265.80	Facility		$645.65	$1,995.26	$4,265.80
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $141.25 / $281.84	Professional		$75.86	$141.25	$281.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $162.18	Professional		$54.95	$104.71	$162.18