Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $1,000.00 / $17,782.79	Facility		$134.90	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $389.05	Professional		$70.79	$104.71	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $478.63	Facility		$97.72	$97.72	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $257.04	Professional		$79.43	$128.82	$257.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $117.49 / $223.87	Facility		$52.48	$117.49	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $123.03 / $213.80	Professional		$52.48	$123.03	$213.80
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 $128.82 / $165.96 / $173.78	Facility		$128.82	$165.96	$173.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $114.82 / $117.49	Facility		$45.71	$114.82	$117.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $218.78	Professional		$100.00	$169.82	$218.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $831.76 / $1,584.89	Facility		$602.56	$831.76	$1,584.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $229.09	Professional		$117.49	$165.96	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,096.48 / $2,511.89	Facility		$154.88	$1,096.48	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $218.78	Professional		$85.11	$117.49	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $100.00 / $165.96	Professional		$58.88	$100.00	$165.96