Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $524.81 / $17,782.79	Facility		$199.53	$524.81	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $165.96 / $398.11	Professional		$95.50	$165.96	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $1,047.13	Facility		$707.95	$870.96	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $213.80 / $457.09	Professional		$120.23	$213.80	$457.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $223.87 / $660.69	Facility		$117.49	$223.87	$660.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $218.78 / $467.74	Professional		$117.49	$218.78	$467.74
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 $229.09 / $309.03 / $331.13	Facility		$229.09	$309.03	$331.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $239.88	Facility		$223.87	$223.87	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $245.47 / $416.87	Professional		$141.25	$245.47	$416.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,949.84 / $3,715.35	Facility		$1,445.44	$1,949.84	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $389.05	Professional		$134.90	$229.09	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,454.71 / $4,786.30	Facility		$891.25	$2,454.71	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $380.19	Professional		$123.03	$208.93	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $165.96 / $234.42	Professional		$87.10	$165.96	$234.42