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 / $3,715.35	Facility		$354.81	$1,698.24	$3,715.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $302.00 / $446.68	Professional		$223.87	$302.00	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $831.76 / $977.24	Facility		$389.05	$831.76	$977.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $371.54 / $1,737.80	Facility		$338.84	$371.54	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $371.54 / $630.96	Professional		$302.00	$371.54	$630.96
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 / $371.54 / $524.81	Facility		$371.54	$371.54	$524.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $660.69 / $1,122.02	Facility		$371.54	$660.69	$1,122.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $446.68	Professional		$338.84	$338.84	$446.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $562.34 / $1,000.00	Facility		$398.11	$562.34	$1,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $338.84 / $416.87	Professional		$316.23	$338.84	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $446.68 / $446.68	Facility		$371.54	$446.68	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $416.87	Professional		$158.49	$158.49	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $371.54 / $676.08	Professional		$169.82	$371.54	$676.08