Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $3,548.13 / $18,620.87	Facility		$457.09	$3,548.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $302.00 / $724.44	Professional		$223.87	$302.00	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $501.19 / $562.34	Facility		$467.74	$501.19	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $398.11 / $741.31	Professional		$245.47	$398.11	$741.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $363.08 / $616.60	Facility		$257.04	$363.08	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $616.60	Professional		$257.04	$380.19	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $467.74 / $489.78	Facility		$380.19	$467.74	$489.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $512.86 / $707.95	Professional		$331.13	$512.86	$707.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $5,754.40 / $7,244.36	Facility		$5,754.40	$5,754.40	$7,244.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $467.74 / $630.96	Professional		$338.84	$467.74	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $549.54 / $5,754.40	Facility		$158.49	$549.54	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $676.08	Professional		$257.04	$380.19	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $239.88 / $398.11	Professional		$208.93	$239.88	$398.11