Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $1,000.00 / $17,782.79	Facility		$102.33	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $138.04 / $331.13	Professional		$50.12	$138.04	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $257.04	Facility		$154.88	$154.88	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $158.49 / $436.52	Professional		$81.28	$158.49	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $186.21 / $933.25	Facility		$79.43	$186.21	$933.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $154.88 / $371.54	Professional		$81.28	$154.88	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $269.15 / $309.03	Facility		$177.83	$269.15	$309.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $213.80	Facility		$208.93	$208.93	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $173.78 / $398.11	Professional		$70.79	$173.78	$398.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,951.21 / $5,623.41	Facility		$1,949.84	$2,951.21	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $162.18 / $363.08	Professional		$77.62	$162.18	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,235.94 / $6,760.83	Facility		$1,698.24	$3,235.94	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $154.88 / $380.19	Professional		$67.61	$154.88	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $83.18 / $229.09	Professional		$44.67	$83.18	$229.09