Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $1,288.25 / $2,818.38	Facility		$263.03	$1,288.25	$2,818.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $338.84	Professional		$169.82	$223.87	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $630.96 / $724.44	Facility		$295.12	$630.96	$724.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $281.84 / $1,318.26	Facility		$257.04	$281.84	$1,318.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $281.84 / $478.63	Professional		$223.87	$281.84	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $489.78	Facility		$281.84	$281.84	$489.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $489.78 / $851.14	Facility		$281.84	$489.78	$851.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $338.84	Professional		$257.04	$257.04	$338.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $426.58 / $776.25	Facility		$295.12	$426.58	$776.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $257.04 / $316.23	Professional		$239.88	$257.04	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $338.84 / $338.84	Facility		$281.84	$338.84	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $316.23	Professional		$117.49	$117.49	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $281.84 / $512.86	Professional		$125.89	$281.84	$512.86