Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,122.02 / $2,454.71	Facility		$234.42	$1,122.02	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $199.53 / $316.23	Professional		$147.91	$199.53	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $512.86 / $645.65	Facility		$251.19	$512.86	$645.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $251.19 / $1,148.15	Facility		$204.17	$251.19	$1,148.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $426.58	Professional		$204.17	$251.19	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $275.42 / $436.52	Facility		$223.87	$275.42	$436.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $436.52 / $741.31	Facility		$251.19	$436.52	$741.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $295.12	Professional		$223.87	$223.87	$295.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $371.54 / $676.08	Facility		$263.03	$371.54	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $223.87 / $275.42	Professional		$208.93	$223.87	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $295.12 / $295.12	Facility		$251.19	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $275.42	Professional		$104.71	$104.71	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $251.19 / $446.68	Professional		$112.20	$251.19	$446.68