Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $6,456.54 / $20,892.96	Facility		$1,737.80	$6,456.54	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $52.48	Professional		$19.95	$28.18	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $83.18 / $151.36	Professional		$45.71	$83.18	$151.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $93.33 / $645.65	Facility		$34.67	$93.33	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $87.10 / $199.53	Professional		$34.67	$87.10	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $51.29 / $54.95	Facility		$41.69	$51.29	$54.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $52.48 / $52.48	Facility		$28.84	$52.48	$52.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $141.25	Professional		$35.48	$56.23	$141.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $707.95 / $1,348.96	Facility		$537.03	$707.95	$1,348.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $77.62 / $138.04	Professional		$29.51	$77.62	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $954.99 / $2,041.74	Facility		$645.65	$954.99	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $104.71	Professional		$26.92	$39.81	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $74.13 / $104.71	Professional		$54.95	$74.13	$104.71