Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,000.00 / $17,782.79	Facility		$199.53	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $218.78 / $524.81	Professional		$95.50	$218.78	$524.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $1,348.96	Facility		$707.95	$870.96	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $275.42 / $724.44	Professional		$112.20	$275.42	$724.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $263.03 / $870.96	Facility		$112.20	$263.03	$870.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $257.04 / $707.95	Professional		$112.20	$257.04	$707.95
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 $316.23 / $489.78 / $549.54	Facility		$316.23	$489.78	$549.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $371.54	Facility		$363.08	$363.08	$371.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $331.13 / $676.08	Professional		$151.36	$331.13	$676.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,570.40 / $4,897.79	Facility		$1,862.09	$2,570.40	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $302.00 / $616.60	Professional		$141.25	$302.00	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $3,090.30 / $5,011.87	Facility		$891.25	$3,090.30	$5,011.87
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $275.42 / $602.56	Professional		$125.89	$275.42	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $177.83 / $398.11	Professional		$93.33	$177.83	$398.11