Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $741.31 / $17,782.79	Facility		$131.83	$741.31	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $213.80	Professional		$63.10	$91.20	$213.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $165.96 / $165.96	Professional	50	$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $478.63	Facility		$112.20	$112.20	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $251.19	Professional		$79.43	$123.03	$251.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $109.65 / $213.80	Facility		$61.66	$109.65	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $112.20 / $199.53	Professional		$61.66	$112.20	$199.53
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 $112.20 / $151.36 / $165.96	Facility		$112.20	$151.36	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $109.65 / $112.20	Facility		$51.29	$109.65	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $162.18 / $208.93	Professional		$97.72	$162.18	$208.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,884.03 / $5,495.41	Facility		$1,862.09	$2,884.03	$5,495.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $218.78	Professional		$109.65	$158.49	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $3,467.37 / $6,918.31	Facility		$602.56	$3,467.37	$6,918.31
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $208.93	Professional		$83.18	$114.82	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $100.00 / $162.18	Professional		$57.54	$100.00	$162.18