Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $1,000.00 / $12,302.69	Facility		$114.82	$1,000.00	$12,302.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $120.23 / $309.03	Professional		$56.23	$120.23	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $218.78	Facility		$131.83	$131.83	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $181.97 / $363.08	Professional		$95.50	$181.97	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $177.83 / $2,818.38	Facility		$93.33	$177.83	$2,818.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $169.82 / $331.13	Professional		$95.50	$169.82	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $239.88 / $257.04	Facility		$173.78	$239.88	$257.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $173.78 / $338.84	Professional		$85.11	$173.78	$338.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,120.11 / $17,378.01	Facility		$5,888.44	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $162.18 / $309.03	Professional		$89.13	$162.18	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $12,022.64 / $19,952.62	Facility		$2,454.71	$12,022.64	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $158.49 / $323.59	Professional		$77.62	$158.49	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $107.15 / $190.55	Professional		$56.23	$107.15	$190.55