Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $489.78 / $1,778.28	Facility		$95.50	$489.78	$1,778.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $245.47 / $575.44	Professional		$43.65	$245.47	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $616.60 / $794.33	Facility		$53.70	$616.60	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $309.03 / $416.87	Professional		$28.84	$309.03	$416.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $316.23 / $812.83	Facility		$66.07	$316.23	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $331.13 / $812.83	Professional		$81.28	$331.13	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $269.15 / $323.59	Professional		$75.86	$269.15	$323.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $575.44	Facility		$302.00	$302.00	$575.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $524.81 / $912.01	Facility		$302.00	$524.81	$912.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $363.08	Professional		$275.42	$275.42	$363.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $457.09 / $831.76	Facility		$316.23	$457.09	$831.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $269.15 / $338.84	Professional		$257.04	$269.15	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $363.08 / $363.08	Facility		$302.00	$363.08	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $125.89 / $338.84	Professional		$24.55	$125.89	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $302.00 / $549.54	Professional		$134.90	$302.00	$549.54