Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $1,000.00 / $17,782.79	Facility		$213.80	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $177.83 / $426.58	Professional		$102.33	$177.83	$426.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	50	$263.03	$263.03	$263.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $295.12	Facility		$177.83	$177.83	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $309.03 / $524.81	Professional		$177.83	$309.03	$524.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $275.42 / $512.86	Facility		$147.91	$275.42	$512.86
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $562.34 / $891.25 / $1,621.81	Facility	50	$562.34	$891.25	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $478.63	Professional		$154.88	$275.42	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $72.44	Professional		$32.36	$33.11	$72.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $346.74 / $380.19	Facility		$245.47	$346.74	$380.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $257.04	Facility		$251.19	$251.19	$257.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $478.63	Professional		$154.88	$275.42	$478.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $691.83 / $1,318.26	Facility		$524.81	$691.83	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $1,047.13 / $1,995.26	Facility	50	$794.33	$1,047.13	$1,995.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $257.04 / $436.52	Professional		$162.18	$257.04	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $891.25 / $2,041.74	Facility		$645.65	$891.25	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $239.88 / $457.09	Professional		$134.90	$239.88	$457.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $194.98 / $275.42	Professional		$104.71	$194.98	$275.42