Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $1,862.09 / $4,073.80	Facility		$389.05	$1,862.09	$4,073.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $338.84 / $575.44	Professional		$245.47	$338.84	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $912.01 / $1,047.13	Facility		$426.58	$912.01	$1,047.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $407.38 / $1,905.46	Facility		$371.54	$407.38	$1,905.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $407.38 / $691.83	Professional		$331.13	$407.38	$691.83
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 $371.54 / $446.68 / $724.44	Facility		$371.54	$446.68	$724.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $724.44 / $1,230.27	Facility		$407.38	$724.44	$1,230.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $489.78	Professional		$371.54	$371.54	$489.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $616.60 / $1,122.02	Facility		$426.58	$616.60	$1,122.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $371.54 / $457.09	Professional		$346.74	$371.54	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $489.78 / $489.78	Facility		$407.38	$489.78	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $457.09	Professional		$173.78	$190.55	$457.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $407.38 / $741.31	Professional		$186.21	$407.38	$741.31