Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $446.68 / $512.86	Facility		$251.19	$446.68	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $616.60	Professional		$158.49	$204.17	$616.60
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 $269.15 / $416.87 / $630.96	Professional		$269.15	$416.87	$630.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $501.19 / $1,819.70	Facility		$323.59	$501.19	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $457.09 / $588.84	Professional		$323.59	$457.09	$588.84
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 $309.03 / $380.19 / $398.11	Facility		$309.03	$380.19	$398.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $446.68 / $549.54	Professional		$263.03	$446.68	$549.54
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 $269.15 / $416.87 / $562.34	Professional		$269.15	$416.87	$562.34
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 $147.91 / $208.93 / $549.54	Professional		$147.91	$208.93	$549.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $263.03 / $371.54	Professional		$223.87	$263.03	$371.54