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 $107.15 / $154.88 / $407.38	Professional		$107.15	$154.88	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $467.74 / $630.96	Facility		$131.83	$467.74	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $416.87	Professional		$123.03	$213.80	$416.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $234.42 / $436.52	Facility		$131.83	$234.42	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $213.80 / $354.81	Professional		$120.23	$213.80	$354.81
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 $204.17 / $288.40 / $295.12	Facility		$204.17	$288.40	$295.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $199.53 / $199.53	Facility		$138.04	$199.53	$199.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $263.03 / $389.05	Professional		$154.88	$263.03	$389.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $4,365.16 / $8,317.64	Facility		$2,884.03	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $234.42 / $323.59	Professional		$173.78	$234.42	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $4,897.79 / $8,709.64	Facility		$933.25	$4,897.79	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $316.23	Professional		$117.49	$186.21	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $218.78	Professional		$102.33	$154.88	$218.78