Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $1,000.00 / $17,782.79	Facility		$83.18	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $169.82	Professional		$40.74	$77.62	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $112.20	Facility		$67.61	$67.61	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $218.78	Professional		$66.07	$117.49	$218.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $107.15 / $208.93	Facility		$63.10	$107.15	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $102.33 / $181.97	Professional		$63.10	$102.33	$181.97
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 $107.15 / $134.90 / $154.88	Facility		$107.15	$134.90	$154.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $104.71	Facility		$100.00	$100.00	$104.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $104.71 / $194.98	Professional		$57.54	$104.71	$194.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $851.14	Facility		$302.00	$446.68	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $177.83	Professional		$61.66	$102.33	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $501.19 / $1,862.09	Facility		$363.08	$501.19	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $97.72 / $186.21	Professional		$53.70	$97.72	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $70.79 / $114.82	Professional		$38.02	$70.79	$114.82