Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $489.78 / $562.34	Facility		$275.42	$489.78	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $229.09 / $676.08	Professional		$173.78	$229.09	$676.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,096.48 / $1,905.46	Facility		$512.86	$1,096.48	$1,905.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $457.09 / $691.83	Professional		$275.42	$457.09	$691.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $549.54 / $1,819.70	Facility		$346.74	$549.54	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $660.69	Professional		$346.74	$501.19	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $416.87 / $446.68	Facility		$316.23	$416.87	$446.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $295.12	Facility		$288.40	$288.40	$295.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $489.78 / $602.56	Professional		$288.40	$489.78	$602.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,148.15 / $2,238.72	Facility		$758.58	$1,148.15	$2,238.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $467.74 / $630.96	Professional		$302.00	$467.74	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,513.56 / $2,691.53	Facility		$1,122.02	$1,513.56	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $616.60	Professional		$154.88	$229.09	$616.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $407.38	Professional		$245.47	$288.40	$407.38