Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,905.46 / $4,265.80	Facility		$398.11	$1,905.46	$4,265.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $346.74 / $537.03	Professional		$257.04	$346.74	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $954.99 / $1,096.48	Facility		$446.68	$954.99	$1,096.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $426.58 / $676.08	Facility		$338.84	$426.58	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $426.58 / $724.44	Professional		$338.84	$426.58	$724.44
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 $380.19 / $467.74 / $741.31	Facility		$380.19	$467.74	$741.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $741.31 / $1,288.25	Facility		$426.58	$741.31	$1,288.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $512.86	Professional		$380.19	$380.19	$512.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $645.65 / $1,174.90	Facility		$446.68	$645.65	$1,174.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $380.19 / $478.63	Professional		$363.08	$380.19	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $512.86 / $512.86	Facility		$426.58	$512.86	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $478.63	Professional		$177.83	$177.83	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $426.58 / $776.25	Professional		$190.55	$426.58	$776.25