Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $2,290.87 / $17,782.79	Facility		$112.20	$2,290.87	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $169.82	Professional		$57.54	$79.43	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $467.74 / $630.96	Facility		$63.10	$467.74	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $239.88	Professional		$67.61	$114.82	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $125.89 / $239.88	Facility		$70.79	$125.89	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $114.82 / $186.21	Professional		$64.57	$114.82	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $48.98	Professional		$32.36	$33.11	$48.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $147.91 / $162.18	Facility		$112.20	$147.91	$162.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $100.00 / $102.33	Facility		$64.57	$100.00	$102.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $199.53	Professional		$83.18	$138.04	$199.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $4,365.16 / $8,317.64	Facility		$3,162.28	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $120.23 / $173.78	Professional		$91.20	$120.23	$173.78
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 $63.10 / $97.72 / $169.82	Professional		$63.10	$97.72	$169.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $79.43 / $112.20	Professional		$53.70	$79.43	$112.20