Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $229.09 / $1,659.59	Professional		$190.55	$229.09	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $331.13	Facility		$269.15	$269.15	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $269.15 / $331.13	Professional		$229.09	$269.15	$331.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $407.38	Facility		$398.11	$398.11	$407.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $407.38	Professional		$398.11	$398.11	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $275.42 / $338.84	Professional		$75.86	$275.42	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $389.05 / $407.38	Facility		$380.19	$389.05	$407.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $389.05 / $389.05	Professional		$380.19	$389.05	$389.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $338.84 / $524.81	Facility		$31.62	$338.84	$524.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $338.84	Professional		$31.62	$44.67	$338.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $33.11	Professional		$26.92	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $173.78 / $295.12	Facility		$19.05	$173.78	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $190.55 / $371.54	Professional		$181.97	$190.55	$371.54