Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $239.88 / $1,202.26	Facility		$74.13	$239.88	$1,202.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $112.20 / $239.88	Professional		$40.74	$112.20	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $131.83 / $338.84	Professional		$50.12	$131.83	$338.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $125.89 / $316.23	Facility		$47.86	$125.89	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $114.82 / $295.12	Professional		$45.71	$114.82	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $75.86	Professional		$28.18	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $245.47 / $263.03	Facility		$169.82	$245.47	$263.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $169.82 / $338.84	Professional		$58.88	$169.82	$338.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $954.99 / $1,819.70	Facility		$616.60	$954.99	$1,819.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $154.88 / $281.84	Professional		$57.54	$154.88	$281.84
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 $46.77 / $120.23 / $263.03	Professional		$46.77	$120.23	$263.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $69.18 / $194.98	Professional		$36.31	$69.18	$194.98