Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $1,000.00 / $17,782.79	Facility		$223.87	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $331.13	Professional		$104.71	$154.88	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $467.74 / $630.96	Facility		$223.87	$467.74	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $218.78 / $416.87	Professional		$123.03	$218.78	$416.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $234.42 / $457.09	Facility		$138.04	$234.42	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $218.78 / $363.08	Professional		$123.03	$218.78	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $69.18	Professional		$32.36	$33.11	$69.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $288.40 / $316.23	Facility		$213.80	$288.40	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $199.53 / $204.17	Facility		$144.54	$199.53	$204.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $398.11	Professional		$147.91	$251.19	$398.11
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 $169.82 / $239.88 / $331.13	Professional		$169.82	$239.88	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $1,819.70 / $3,715.35	Facility		$269.15	$1,819.70	$3,715.35
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $323.59	Professional		$120.23	$190.55	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $229.09	Professional		$104.71	$165.96	$229.09