Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $1,737.80 / $20,892.96	Facility		$204.17	$1,737.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $302.00	Professional		$100.00	$125.89	$302.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $707.95 / $954.99	Facility		$501.19	$707.95	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $331.13	Professional		$117.49	$186.21	$331.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $204.17 / $281.84	Facility		$112.20	$204.17	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $177.83 / $275.42	Professional		$104.71	$177.83	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $63.10	Professional		$32.36	$33.11	$63.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $213.80 / $223.87	Facility		$181.97	$213.80	$223.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $323.59	Professional		$151.36	$234.42	$323.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $281.84	Professional		$169.82	$213.80	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,258.93 / $5,754.40	Facility		$707.95	$1,258.93	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $288.40	Professional		$107.15	$158.49	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $112.20 / $186.21	Professional		$97.72	$112.20	$186.21