Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $1,548.82 / $17,782.79	Facility		$169.82	$1,548.82	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $257.04	Professional		$83.18	$120.23	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $128.82 / $154.88	Facility		$77.62	$128.82	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $165.96 / $338.84	Professional		$93.33	$165.96	$338.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $181.97 / $363.08	Facility		$97.72	$181.97	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $281.84	Professional		$87.10	$169.82	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $58.88	Professional		$32.36	$33.11	$58.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $194.98 / $245.47	Facility		$162.18	$194.98	$245.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $154.88 / $158.49	Facility		$100.00	$154.88	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $295.12	Professional		$123.03	$199.53	$295.12
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 $138.04 / $186.21 / $263.03	Professional		$138.04	$186.21	$263.03
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 $93.33 / $144.54 / $257.04	Professional		$93.33	$144.54	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $147.91	Professional		$70.79	$104.71	$147.91