Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $100.00 / $8,709.64	Facility		$83.18	$100.00	$8,709.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $47.86 / $131.83	Professional		$38.90	$47.86	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $89.13 / $131.83	Professional		$60.26	$89.13	$131.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $104.71 / $1,230.27	Facility		$58.88	$104.71	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $100.00 / $436.52	Professional		$57.54	$100.00	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $42.66 / $70.79	Professional		$25.12	$42.66	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $87.10 / $91.20	Facility		$72.44	$87.10	$91.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $60.26	Facility		$58.88	$58.88	$60.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $102.33 / $128.82	Professional		$60.26	$102.33	$128.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,230.27 / $2,344.23	Facility		$851.14	$1,230.27	$2,344.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $114.82	Professional		$60.26	$87.10	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,659.59 / $3,548.13	Facility		$645.65	$1,659.59	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $74.13 / $128.82	Professional		$45.71	$74.13	$128.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $72.44	Professional		$38.02	$51.29	$72.44