Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $138.04 / $489.78	Facility		$67.61	$138.04	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $144.54	Professional		$47.86	$64.57	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,348.96 / $1,778.28	Facility		$933.25	$1,348.96	$1,778.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $229.09	Professional		$58.88	$117.49	$229.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $131.83 / $1,000.00	Facility		$83.18	$131.83	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $117.49 / $186.21	Professional		$64.57	$117.49	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $37.15	Professional		$32.36	$33.11	$37.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $114.82 / $263.03	Facility		$95.50	$114.82	$263.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $117.49	Professional		$104.71	$104.71	$117.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $79.43	Facility		$77.62	$77.62	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $173.78	Professional		$79.43	$128.82	$173.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,096.48 / $2,089.30	Facility		$776.25	$1,096.48	$2,089.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $162.18	Professional		$79.43	$123.03	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,318.26 / $2,398.83	Facility		$977.24	$1,318.26	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $87.10 / $208.93	Professional		$58.88	$87.10	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $56.23 / $69.18	Professional		$48.98	$56.23	$69.18