Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $3,548.13 / $7,943.28	Facility		$741.31	$3,548.13	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $630.96 / $954.99	Professional		$478.63	$630.96	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,778.28 / $2,041.74	Facility		$831.76	$1,778.28	$2,041.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $794.33 / $3,715.35	Facility		$707.95	$794.33	$3,715.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $1,348.96	Professional		$630.96	$794.33	$1,348.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $1,122.02	Facility		$794.33	$794.33	$1,122.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,380.38 / $2,398.83	Facility		$794.33	$1,380.38	$2,398.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $954.99	Professional		$707.95	$707.95	$954.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,202.26 / $2,187.76	Facility		$831.76	$1,202.26	$2,187.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $707.95 / $891.25	Professional		$676.08	$707.95	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $891.25	Professional		$331.13	$331.13	$891.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $794.33 / $1,445.44	Professional		$354.81	$794.33	$1,445.44