Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $1,348.96 / $3,019.95	Facility		$281.84	$1,348.96	$3,019.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $363.08	Professional		$181.97	$239.88	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $660.69 / $776.25	Facility		$316.23	$660.69	$776.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $302.00 / $1,380.38	Facility		$269.15	$302.00	$1,380.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $302.00 / $512.86	Professional		$239.88	$302.00	$512.86
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 $302.00 / $302.00 / $426.58	Facility		$302.00	$302.00	$426.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $524.81 / $912.01	Facility		$302.00	$524.81	$912.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $363.08	Professional		$269.15	$269.15	$363.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $457.09 / $794.33	Facility		$316.23	$457.09	$794.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $269.15 / $338.84	Professional		$257.04	$269.15	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $363.08 / $363.08	Facility		$302.00	$363.08	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $338.84	Professional		$125.89	$125.89	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $302.00 / $537.03	Professional		$134.90	$302.00	$537.03