Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $1,819.70 / $4,073.80	Facility		$380.19	$1,819.70	$4,073.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $323.59 / $398.11	Professional		$114.82	$323.59	$398.11
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 $363.08 / $407.38 / $1,905.46	Facility		$363.08	$407.38	$1,905.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $407.38 / $691.83	Professional		$323.59	$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 $363.08 / $446.68 / $707.95	Facility		$363.08	$446.68	$707.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $707.95 / $1,230.27	Facility		$407.38	$707.95	$1,230.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $489.78	Professional		$363.08	$363.08	$489.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $616.60 / $1,071.52	Facility		$426.58	$616.60	$1,071.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $363.08 / $457.09	Professional		$346.74	$363.08	$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 $69.18 / $100.00 / $407.38	Professional		$69.18	$100.00	$407.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $407.38 / $741.31	Professional		$181.97	$407.38	$741.31