Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $707.95 / $1,905.46	Facility		$446.68	$707.95	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $295.12 / $630.96	Professional		$218.78	$295.12	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $691.83 / $870.96	Facility		$338.84	$691.83	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $380.19 / $501.19	Professional		$169.82	$380.19	$501.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $407.38 / $1,122.02	Facility		$323.59	$407.38	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $407.38 / $891.25	Professional		$323.59	$407.38	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $288.40 / $346.74	Professional		$75.86	$288.40	$346.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $616.60	Facility		$323.59	$323.59	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $562.34 / $977.24	Facility		$323.59	$562.34	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $389.05	Professional		$295.12	$295.12	$389.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $489.78 / $891.25	Facility		$338.84	$489.78	$891.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $295.12 / $363.08	Professional		$275.42	$295.12	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $389.05 / $389.05	Facility		$323.59	$389.05	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $138.04 / $363.08	Professional		$134.90	$138.04	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $323.59 / $588.84	Professional		$144.54	$323.59	$588.84