Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $1,698.24 / $3,801.89	Facility		$354.81	$1,698.24	$3,801.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $309.03 / $457.09	Professional		$251.19	$309.03	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $851.14 / $977.24	Facility		$398.11	$851.14	$977.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $380.19 / $1,778.28	Facility		$338.84	$380.19	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $380.19 / $645.65	Professional		$302.00	$380.19	$645.65
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 $338.84 / $416.87 / $660.69	Facility		$338.84	$416.87	$660.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $660.69 / $1,148.15	Facility		$380.19	$660.69	$1,148.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $457.09	Professional		$338.84	$338.84	$457.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $575.44 / $1,047.13	Facility		$398.11	$575.44	$1,047.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $426.58	Professional		$323.59	$338.84	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $457.09 / $457.09	Facility		$380.19	$457.09	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $426.58	Professional		$158.49	$158.49	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $380.19 / $691.83	Professional		$169.82	$380.19	$691.83