Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $275.42 / $18,620.87	Facility		$165.96	$275.42	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $489.78	Professional		$87.10	$128.82	$489.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $173.78	Facility		$104.71	$104.71	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $331.13	Professional		$128.82	$208.93	$331.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $204.17 / $316.23	Facility		$112.20	$204.17	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $288.40	Professional		$112.20	$194.98	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $57.54	Professional		$32.36	$33.11	$57.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $213.80 / $234.42	Facility		$147.91	$213.80	$234.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $162.18	Facility		$154.88	$154.88	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $213.80 / $295.12	Professional		$120.23	$213.80	$295.12
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 $125.89 / $181.97 / $269.15	Professional		$125.89	$181.97	$269.15
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 $107.15 / $154.88 / $302.00	Professional		$107.15	$154.88	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $177.83	Professional		$85.11	$125.89	$177.83