Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $1,000.00 / $17,782.79	Facility		$281.84	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $602.56	Professional		$134.90	$190.55	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $478.63	Facility		$204.17	$204.17	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $257.04 / $478.63	Professional		$158.49	$257.04	$478.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $218.78 / $416.87	Facility		$112.20	$218.78	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $223.87 / $398.11	Professional		$112.20	$223.87	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $302.00 / $316.23	Facility		$218.78	$302.00	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $208.93 / $213.80	Facility		$93.33	$208.93	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $338.84 / $436.52	Professional		$204.17	$338.84	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $6,606.93 / $12,589.25	Facility		$4,365.16	$6,606.93	$12,589.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $457.09	Professional		$208.93	$309.03	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $7,413.10 / $13,489.63	Facility		$1,380.38	$7,413.10	$13,489.63
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $229.09 / $426.58	Professional		$165.96	$229.09	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $190.55 / $309.03	Professional		$20.89	$190.55	$309.03