Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $575.44 / $1,862.09	Facility		$257.04	$575.44	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $512.86	Professional		$138.04	$223.87	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $588.84 / $676.08	Facility		$275.42	$588.84	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $275.42 / $389.05	Professional		$128.82	$275.42	$389.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $323.59 / $1,174.90	Facility		$263.03	$323.59	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $323.59 / $724.44	Professional		$263.03	$323.59	$724.44
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 $263.03 / $275.42 / $398.11	Facility		$263.03	$275.42	$398.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $457.09 / $794.33	Facility		$263.03	$457.09	$794.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $316.23	Professional		$234.42	$234.42	$316.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $398.11 / $724.44	Facility		$275.42	$398.11	$724.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $295.12	Professional		$223.87	$234.42	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $316.23 / $316.23	Facility		$263.03	$316.23	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $295.12	Professional		$109.65	$109.65	$295.12