Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $4,265.80 / $9,549.93	Facility		$891.25	$4,265.80	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,148.15	Professional		$575.44	$758.58	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $2,187.76 / $2,454.71	Facility		$977.24	$2,187.76	$2,454.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $954.99 / $1,513.56	Facility		$758.58	$954.99	$1,513.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $954.99 / $1,621.81	Professional		$758.58	$954.99	$1,621.81
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 $851.14 / $1,047.13 / $1,659.59	Facility		$851.14	$1,047.13	$1,659.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,659.59 / $2,818.38	Facility		$954.99	$1,659.59	$2,818.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $851.14 / $1,148.15	Professional		$851.14	$851.14	$1,148.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $2,630.27	Facility		$1,000.00	$1,412.54	$2,630.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $851.14 / $1,071.52	Professional		$812.83	$851.14	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,148.15 / $1,148.15	Facility		$954.99	$1,148.15	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $1,071.52	Professional		$398.11	$398.11	$1,071.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $954.99 / $1,698.24	Professional		$426.58	$954.99	$1,698.24