Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $524.81 / $660.69	Professional		$398.11	$524.81	$660.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $707.95 / $1,122.02	Facility		$562.34	$707.95	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $707.95 / $1,202.26	Professional		$562.34	$707.95	$1,202.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $1,000.00	Facility		$707.95	$707.95	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $891.25	Professional		$630.96	$630.96	$891.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $630.96 / $794.33	Professional		$602.56	$630.96	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $851.14	Professional		$295.12	$295.12	$851.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23