Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,698.24 / $1,698.24	Facility		$100.00	$1,698.24	$1,698.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $234.42	Professional		$60.26	$100.00	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,659.59 / $2,754.23	Facility		$1,071.52	$1,659.59	$2,754.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $229.09 / $2,511.89	Facility		$131.83	$229.09	$2,511.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $204.17 / $295.12	Professional		$131.83	$204.17	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $79.43	Professional		$32.36	$50.12	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $128.82 / $524.81	Facility		$50.12	$128.82	$524.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $120.23	Facility		$117.49	$117.49	$120.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $251.19	Professional		$120.23	$177.83	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $3,162.28	Facility		$1,047.13	$1,621.81	$3,162.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $251.19	Professional		$125.89	$186.21	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,089.30 / $3,801.89	Facility		$1,548.82	$2,089.30	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $275.42	Professional		$81.28	$125.89	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $125.89	Professional		$66.07	$89.13	$125.89