Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $288.40	Professional		$144.54	$223.87	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $794.33 / $1,000.00	Facility		$309.03	$794.33	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $245.47	Professional		$74.13	$134.90	$245.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $81.28 / $630.96	Facility		$46.77	$81.28	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $75.86 / $173.78	Professional		$44.67	$75.86	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $28.18 / $31.62	Facility		$25.12	$28.18	$31.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $234.42	Professional		$109.65	$177.83	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $676.08 / $1,318.26	Facility		$478.63	$676.08	$1,318.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $229.09	Professional		$112.20	$169.82	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $912.01 / $1,621.81	Facility		$676.08	$912.01	$1,621.81
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $263.03 / $645.65	Professional		$97.72	$263.03	$645.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $36.31 / $60.26	Professional		$31.62	$36.31	$60.26