Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $645.65 / $1,862.09	Facility		$323.59	$645.65	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $630.96	Professional		$208.93	$295.12	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $707.95 / $933.25	Facility		$331.13	$707.95	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $371.54 / $457.09	Professional		$169.82	$371.54	$457.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $398.11 / $1,000.00	Facility		$323.59	$398.11	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $398.11 / $891.25	Professional		$323.59	$398.11	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $602.56	Facility		$323.59	$323.59	$602.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $562.34 / $954.99	Facility		$323.59	$562.34	$954.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $380.19	Professional		$288.40	$288.40	$380.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $478.63 / $870.96	Facility		$338.84	$478.63	$870.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $380.19	Professional		$269.15	$288.40	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $380.19 / $380.19	Facility		$323.59	$380.19	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $354.81	Professional		$134.90	$134.90	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $323.59 / $575.44	Professional		$144.54	$323.59	$575.44