Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $263.03 / $1,047.13	Facility		$169.82	$263.03	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $239.88	Professional		$77.62	$107.15	$239.88
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 $89.13 / $162.18 / $309.03	Professional		$89.13	$162.18	$309.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $199.53 / $1,000.00	Facility		$109.65	$199.53	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $181.97 / $281.84	Professional		$97.72	$181.97	$281.84
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 $141.25 / $194.98 / $213.80	Facility		$141.25	$194.98	$213.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $154.88	Facility		$138.04	$138.04	$154.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $302.00	Professional		$144.54	$223.87	$302.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,071.52 / $2,089.30	Facility		$758.58	$1,071.52	$2,089.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $309.03	Professional		$158.49	$213.80	$309.03
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 $93.33 / $120.23 / $281.84	Professional		$93.33	$120.23	$281.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $114.82 / $190.55	Professional		$100.00	$114.82	$190.55