Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $562.34 / $645.65	Facility		$309.03	$562.34	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $776.25	Professional		$199.53	$257.04	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,096.48 / $1,905.46	Facility		$501.19	$1,096.48	$1,905.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $794.33	Professional		$316.23	$524.81	$794.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $630.96 / $1,819.70	Facility		$389.05	$630.96	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $758.58	Professional		$398.11	$575.44	$758.58
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 $363.08 / $467.74 / $501.19	Facility		$363.08	$467.74	$501.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $338.84	Facility		$331.13	$331.13	$338.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $562.34 / $691.83	Professional		$331.13	$562.34	$691.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,148.15 / $2,238.72	Facility		$741.31	$1,148.15	$2,238.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $524.81 / $724.44	Professional		$346.74	$524.81	$724.44
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 $186.21 / $263.03 / $691.83	Professional		$186.21	$263.03	$691.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $331.13 / $457.09	Professional		$281.84	$331.13	$457.09