Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $288.40 / $371.54	Facility		$151.36	$288.40	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $389.05	Professional		$107.15	$138.04	$389.05
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 $177.83 / $275.42 / $407.38	Professional		$177.83	$275.42	$407.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $331.13 / $1,819.70	Facility		$213.80	$331.13	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $398.11	Professional		$213.80	$309.03	$398.11
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 $204.17 / $245.47 / $331.13	Facility		$204.17	$245.47	$331.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $363.08	Professional		$169.82	$281.84	$363.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,148.15 / $2,238.72	Facility		$812.83	$1,148.15	$2,238.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $354.81	Professional		$169.82	$263.03	$354.81
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 $109.65 / $138.04 / $346.74	Professional		$109.65	$138.04	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $251.19	Professional		$151.36	$177.83	$251.19