Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,047.13 / $3,311.31	Facility		$467.74	$1,047.13	$3,311.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $371.54 / $562.34	Professional		$281.84	$371.54	$562.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,023.29 / $1,202.26	Facility		$489.78	$1,023.29	$1,202.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $467.74 / $2,137.96	Facility		$416.87	$467.74	$2,137.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $467.74 / $794.33	Professional		$371.54	$467.74	$794.33
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 $416.87 / $512.86 / $812.83	Facility		$416.87	$512.86	$812.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $812.83 / $1,412.54	Facility		$467.74	$812.83	$1,412.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $562.34	Professional		$416.87	$416.87	$562.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $691.83 / $1,288.25	Facility		$489.78	$691.83	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $416.87 / $524.81	Professional		$398.11	$416.87	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $562.34	Facility		$467.74	$562.34	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $524.81	Professional		$194.98	$194.98	$524.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $467.74 / $831.76	Professional		$208.93	$467.74	$831.76