Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $7,762.47 / $20,892.96	Facility		$316.23	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $501.19	Professional		$151.36	$199.53	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $275.42 / $512.86	Professional		$165.96	$275.42	$512.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $251.19 / $426.58	Facility		$177.83	$251.19	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $263.03 / $426.58	Professional		$177.83	$263.03	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $61.66	Professional		$32.36	$33.11	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $323.59 / $346.74	Facility		$251.19	$323.59	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $234.42	Facility		$229.09	$229.09	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $363.08 / $489.78	Professional		$234.42	$363.08	$489.78
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 $234.42 / $323.59 / $436.52	Professional		$234.42	$323.59	$436.52
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 $173.78 / $263.03 / $478.63	Professional		$173.78	$263.03	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $169.82 / $281.84	Professional		$147.91	$169.82	$281.84