Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $1,513.56 / $17,782.79	Facility		$363.08	$1,513.56	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $645.65	Professional		$177.83	$251.19	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $676.08 / $1,122.02	Facility		$630.96	$676.08	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $363.08 / $741.31	Professional		$199.53	$363.08	$741.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $354.81 / $831.76	Facility		$199.53	$354.81	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $363.08 / $660.69	Professional		$199.53	$363.08	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $112.20	Professional		$32.36	$33.11	$112.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $446.68 / $512.86	Facility		$323.59	$446.68	$512.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $457.09 / $645.65	Professional		$275.42	$457.09	$645.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,570.40 / $4,897.79	Facility		$1,778.28	$2,570.40	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $407.38 / $602.56	Professional		$263.03	$407.38	$602.56
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 $223.87 / $316.23 / $616.60	Professional		$223.87	$316.23	$616.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $398.11	Professional		$186.21	$281.84	$398.11