Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,000.00 / $17,782.79	Facility		$218.78	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $173.78 / $389.05	Professional		$107.15	$173.78	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $269.15 / $323.59	Facility		$162.18	$269.15	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $223.87 / $467.74	Professional		$123.03	$223.87	$467.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $251.19 / $457.09	Facility		$138.04	$251.19	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $407.38	Professional		$128.82	$229.09	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $323.59 / $354.81	Facility		$229.09	$323.59	$354.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $239.88 / $239.88	Facility		$173.78	$239.88	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $269.15 / $467.74	Professional		$154.88	$269.15	$467.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,548.82 / $2,951.21	Facility		$1,000.00	$1,548.82	$2,951.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $269.15 / $389.05	Professional		$169.82	$269.15	$389.05
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 / $199.53 / $363.08	Professional		$120.23	$199.53	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $190.55 / $269.15	Professional		$100.00	$190.55	$269.15