Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $281.84 / $18,620.87	Facility		$158.49	$281.84	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $398.11	Professional		$85.11	$138.04	$398.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	50	$218.78	$218.78	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $208.93 / $338.84	Professional		$131.83	$208.93	$338.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $199.53 / $630.96	Facility		$112.20	$199.53	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $295.12	Professional		$112.20	$190.55	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $229.09 / $239.88	Facility		$162.18	$229.09	$239.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $165.96	Facility		$162.18	$162.18	$165.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $208.93 / $309.03	Professional		$114.82	$208.93	$309.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,995.26 / $3,801.89	Facility		$1,348.96	$1,995.26	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $281.84	Professional		$125.89	$186.21	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $2,630.27 / $4,897.79	Facility		$933.25	$2,630.27	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $309.03	Professional		$107.15	$169.82	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $181.97	Professional		$77.62	$128.82	$181.97