Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $346.74 / $549.54	Facility		$239.88	$346.74	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $229.09 / $954.99	Professional		$144.54	$229.09	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $251.19 / $346.74	Facility		$123.03	$251.19	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $234.42 / $302.00	Professional		$117.49	$234.42	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $524.81 / $3,467.37	Facility		$316.23	$524.81	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $489.78 / $676.08	Professional		$316.23	$489.78	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $83.18	Professional		$32.36	$33.11	$83.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $457.09 / $549.54	Facility		$371.54	$457.09	$549.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $309.03	Facility		$295.12	$295.12	$309.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $676.08	Professional		$309.03	$501.19	$676.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,454.71 / $4,677.35	Facility		$1,584.89	$2,454.71	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $562.34	Professional		$302.00	$426.58	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,019.95 / $5,495.41	Facility		$2,187.76	$3,019.95	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $371.54	Professional		$138.04	$158.49	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $426.58	Professional		$223.87	$309.03	$426.58