Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $426.58 / $1,995.26	Facility		$134.90	$426.58	$1,995.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $741.31 / $741.31 / $741.31	Facility	52	$741.31	$741.31	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $181.97 / $501.19	Professional		$77.62	$181.97	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $194.98 / $426.58	Professional		$95.50	$194.98	$426.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $194.98 / $426.58	Facility		$93.33	$194.98	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $177.83 / $371.54	Professional		$85.11	$177.83	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $309.03 / $346.74	Facility		$251.19	$309.03	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $229.09	Facility		$223.87	$223.87	$229.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $223.87 / $436.52	Professional		$107.15	$223.87	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $954.99 / $1,819.70	Facility		$691.83	$954.99	$1,819.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $223.87 / $371.54	Professional		$104.71	$223.87	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,258.93 / $2,238.72	Facility		$933.25	$1,258.93	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $181.97 / $363.08	Professional		$89.13	$181.97	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $125.89 / $234.42	Professional		$66.07	$125.89	$234.42