Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $41.69 / $1,023.29	Facility		$24.55	$41.69	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $38.02 / $602.56	Professional		$16.98	$38.02	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $61.66 / $954.99	Professional		$14.79	$61.66	$954.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $165.96 / $1,047.13	Facility		$24.55	$165.96	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $53.70 / $1,122.02	Professional		$25.70	$53.70	$1,122.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $724.44 / $851.14	Facility		$194.98	$724.44	$851.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $616.60	Facility		$436.52	$436.52	$616.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $58.88 / $1,023.29	Professional		$23.99	$58.88	$1,023.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $562.34 / $1,096.48	Facility		$371.54	$562.34	$1,096.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $58.88 / $741.31	Professional		$18.20	$58.88	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $758.58 / $1,380.38	Facility		$562.34	$758.58	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $100.00 / $870.96	Professional		$17.38	$100.00	$870.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $29.51 / $588.84	Professional		$15.49	$29.51	$588.84