Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $3,388.44 / $7,413.10	Facility		$707.95	$3,388.44	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $602.56 / $891.25	Professional		$446.68	$602.56	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,659.59 / $1,949.84	Facility		$776.25	$1,659.59	$1,949.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $758.58 / $1,202.26	Facility		$602.56	$758.58	$1,202.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $758.58 / $1,288.25	Professional		$602.56	$758.58	$1,288.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $831.76 / $1,318.26	Facility		$676.08	$831.76	$1,318.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,318.26 / $2,238.72	Facility		$758.58	$1,318.26	$2,238.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $891.25	Professional		$676.08	$676.08	$891.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,122.02 / $1,995.26	Facility		$794.33	$1,122.02	$1,995.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $676.08 / $831.76	Professional		$630.96	$676.08	$831.76
United Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $891.25 / $891.25	Facility		$758.58	$891.25	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $831.76	Professional		$316.23	$316.23	$831.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $758.58 / $1,348.96	Professional		$338.84	$758.58	$1,348.96