Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $213.80 / $9,772.37	Facility		$165.96	$213.80	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $398.11	Professional		$74.13	$102.33	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $3,981.07	Facility		$2,398.83	$2,398.83	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $269.15	Professional		$112.20	$177.83	$269.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $208.93 / $7,943.28	Facility		$123.03	$208.93	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $199.53 / $3,162.28	Professional		$114.82	$199.53	$3,162.28
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 $147.91 / $169.82 / $181.97	Facility		$147.91	$169.82	$181.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $123.03 / $123.03	Facility		$120.23	$123.03	$123.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $204.17 / $263.03	Professional		$123.03	$204.17	$263.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $8,912.51 / $16,982.44	Facility		$5,888.44	$8,912.51	$16,982.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $173.78 / $234.42	Professional		$123.03	$173.78	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,220.18 / $19,498.45	Facility		$1,995.26	$11,220.18	$19,498.45
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $263.03	Professional		$89.13	$147.91	$263.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $151.36	Professional		$79.43	$107.15	$151.36