Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,000.00 / $17,782.79	Facility		$141.25	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $144.54 / $371.54	Professional		$70.79	$144.54	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $251.19	Facility		$151.36	$151.36	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $457.09	Professional		$112.20	$194.98	$457.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $181.97 / $446.68	Facility		$109.65	$181.97	$446.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $389.05	Professional		$109.65	$177.83	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $44.67	Professional		$32.36	$33.11	$44.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $263.03 / $323.59	Facility		$169.82	$263.03	$323.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $213.80 / $407.38	Professional		$97.72	$213.80	$407.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $707.95 / $1,348.96	Facility		$512.86	$707.95	$1,348.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $190.55 / $371.54	Professional		$109.65	$190.55	$371.54
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 $93.33 / $169.82 / $371.54	Professional		$93.33	$169.82	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $120.23 / $245.47	Professional		$63.10	$120.23	$245.47