Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $89.13 / $302.00	Facility		$61.66	$89.13	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $63.10 / $177.83	Professional		$28.84	$63.10	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $79.43 / $281.84	Professional		$33.88	$79.43	$281.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $83.18 / $389.05	Facility		$44.67	$83.18	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $288.40	Professional		$40.74	$77.62	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $190.55 / $275.42	Facility		$83.18	$190.55	$275.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $186.21	Facility		$131.83	$131.83	$186.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $117.49 / $316.23	Professional		$51.29	$117.49	$316.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,513.56 / $2,884.03	Facility		$1,000.00	$1,513.56	$2,884.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $102.33 / $269.15	Professional		$50.12	$102.33	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,412.54 / $2,511.89	Facility		$1,047.13	$1,412.54	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $79.43 / $177.83	Professional		$36.31	$79.43	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $51.29 / $194.98	Professional		$26.92	$51.29	$194.98