Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $691.83	Professional		$83.18	$85.11	$691.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $144.54	Facility		$114.82	$114.82	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $144.54	Professional		$97.72	$114.82	$144.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $218.78	Facility		$162.18	$162.18	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $218.78	Professional		$162.18	$162.18	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $181.97	Professional		$131.83	$147.91	$181.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $165.96 / $208.93	Facility		$158.49	$165.96	$208.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $199.53	Professional		$158.49	$158.49	$199.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $147.91 / $213.80	Facility		$13.18	$147.91	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $18.20 / $147.91	Professional		$13.18	$18.20	$147.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $17.78 / $17.78	Professional		$14.45	$17.78	$17.78
United Facility/Professional Facility Modifier Low / Median / High Price $1.10 / $57.54 / $117.49	Facility		$1.10	$57.54	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $158.49	Professional		$83.18	$85.11	$158.49