Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $1,000.00 / $17,782.79	Facility		$251.19	$1,000.00	$17,782.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,071.52 / $1,071.52 / $1,288.25	Facility	50	$1,071.52	$1,071.52	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $208.93 / $645.65	Professional		$131.83	$208.93	$645.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $346.74 / $1,479.11	Professional	50	$100.00	$346.74	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $478.63	Facility		$380.19	$380.19	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $501.19	Professional		$151.36	$251.19	$501.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $288.40 / $457.09	Facility		$181.97	$288.40	$457.09
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $724.44 / $1,174.90 / $2,089.30	Facility	50	$724.44	$1,174.90	$2,089.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $288.40 / $436.52	Professional		$181.97	$288.40	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $316.23 / $363.08	Facility		$251.19	$316.23	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $213.80 / $218.78	Facility		$144.54	$213.80	$218.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $309.03 / $416.87	Professional		$177.83	$309.03	$416.87
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 Facility Modifier 50 Low / Median / High Price $912.01 / $1,230.27 / $2,344.23	Facility	50	$912.01	$1,230.27	$2,344.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $295.12 / $416.87	Professional		$218.78	$295.12	$416.87
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 $169.82 / $251.19 / $416.87	Professional		$169.82	$251.19	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $190.55 / $316.23	Professional		$21.38	$190.55	$316.23