Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $1,737.80 / $20,892.96	Facility		$125.89	$1,737.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $87.10 / $263.03	Professional		$66.07	$87.10	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $204.17	Professional		$85.11	$134.90	$204.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $147.91 / $186.21	Facility		$83.18	$147.91	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $186.21	Professional		$83.18	$147.91	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $131.83 / $141.25	Facility		$109.65	$131.83	$141.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $194.98	Professional		$91.20	$151.36	$194.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $177.83	Professional		$93.33	$131.83	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,311.31 / $37,153.52	Facility		$1,122.02	$3,311.31	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $186.21	Professional		$69.18	$104.71	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $109.65	Professional		$66.07	$77.62	$109.65