Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $309.03 / $398.11	Facility		$229.09	$309.03	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $426.58	Professional		$123.03	$177.83	$426.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $1,096.48 / $1,905.46	Facility		$338.84	$1,096.48	$1,905.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $331.13 / $467.74	Professional		$194.98	$331.13	$467.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $389.05 / $1,819.70	Facility		$281.84	$389.05	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $478.63	Professional		$269.15	$371.54	$478.63
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 $218.78 / $269.15 / $363.08	Facility		$218.78	$269.15	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $239.88	Facility		$181.97	$181.97	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $398.11	Professional		$181.97	$323.59	$398.11
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 $245.47 / $338.84 / $478.63	Professional		$245.47	$338.84	$478.63
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 $123.03 / $162.18 / $446.68	Professional		$123.03	$162.18	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $186.21 / $263.03	Professional		$158.49	$186.21	$263.03