Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $1,000.00 / $17,782.79	Facility		$338.84	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $575.44	Professional		$169.82	$245.47	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $1,348.96	Facility		$467.74	$562.34	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $323.59 / $630.96	Professional		$177.83	$323.59	$630.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $338.84 / $831.76	Facility		$199.53	$338.84	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $588.84	Professional		$199.53	$331.13	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $398.11 / $426.58	Facility		$302.00	$398.11	$426.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $288.40 / $309.03	Facility		$281.84	$288.40	$309.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $524.81	Professional		$251.19	$398.11	$524.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,570.40 / $4,897.79	Facility		$1,995.26	$2,570.40	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $489.78	Professional		$239.88	$354.81	$489.78
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 $204.17 / $295.12 / $537.03	Professional		$204.17	$295.12	$537.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $323.59	Professional		$169.82	$229.09	$323.59