Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $2,754.23 / $6,025.60	Facility		$575.44	$2,754.23	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $489.78 / $758.58	Professional		$363.08	$489.78	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,348.96 / $1,584.89	Facility		$630.96	$1,348.96	$1,584.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $602.56 / $2,818.38	Facility		$549.54	$602.56	$2,818.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $602.56 / $1,023.29	Professional		$489.78	$602.56	$1,023.29
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 $602.56 / $602.56 / $851.14	Facility		$602.56	$602.56	$851.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,071.52 / $1,819.70	Facility		$602.56	$1,071.52	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $724.44	Professional		$549.54	$549.54	$724.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $912.01 / $1,659.59	Facility		$645.65	$912.01	$1,659.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $549.54 / $676.08	Professional		$512.86	$549.54	$676.08
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $724.44 / $724.44	Facility		$602.56	$724.44	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $676.08	Professional		$257.04	$257.04	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $602.56 / $1,096.48	Professional		$275.42	$602.56	$1,096.48