Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $1,000.00 / $17,782.79	Facility		$190.55	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $229.09 / $630.96	Professional		$93.33	$229.09	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $478.63	Facility		$446.68	$446.68	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $275.42 / $645.65	Professional		$114.82	$275.42	$645.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $257.04 / $645.65	Facility		$125.89	$257.04	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $588.84	Professional		$125.89	$257.04	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $141.25	Professional		$32.36	$33.11	$141.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $426.58 / $489.78	Facility		$302.00	$426.58	$489.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $331.13 / $331.13	Facility		$223.87	$331.13	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $316.23 / $616.60	Professional		$138.04	$316.23	$616.60
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 $177.83 / $331.13 / $616.60	Professional		$177.83	$331.13	$616.60
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 $123.03 / $263.03 / $562.34	Professional		$123.03	$263.03	$562.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $169.82 / $478.63	Professional		$31.62	$169.82	$478.63