Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $3,548.13 / $18,620.87	Facility		$147.91	$3,548.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $281.84	Professional		$72.44	$102.33	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $371.54	Facility		$223.87	$223.87	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $257.04	Professional		$109.65	$165.96	$257.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $190.55 / $870.96	Facility		$131.83	$190.55	$870.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $302.00	Professional		$131.83	$181.97	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $35.48	Professional		$32.36	$33.11	$35.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $158.49 / $173.78	Facility		$131.83	$158.49	$173.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $181.97 / $234.42	Professional		$107.15	$181.97	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $870.96 / $1,621.81	Facility		$645.65	$870.96	$1,621.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $208.93	Professional		$109.65	$158.49	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,148.15 / $2,454.71	Facility		$645.65	$1,148.15	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $141.25 / $229.09	Professional		$83.18	$141.25	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $131.83	Professional		$69.18	$93.33	$131.83