Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,019.95 / $17,782.79	Facility		$630.96	$3,019.95	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $489.78 / $1,202.26	Professional		$288.40	$489.78	$1,202.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $912.01 / $2,818.38	Facility		$562.34	$912.01	$2,818.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $691.83 / $1,348.96	Professional		$416.87	$691.83	$1,348.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $831.76 / $3,235.94	Facility		$489.78	$831.76	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $812.83 / $1,698.24	Professional		$489.78	$812.83	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $213.80	Professional		$32.36	$33.11	$213.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $954.99 / $1,071.52	Facility		$660.69	$954.99	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $977.24	Facility		$724.44	$724.44	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $831.76 / $1,318.26	Professional		$457.09	$831.76	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $8,128.31 / $15,488.17	Facility		$5,370.32	$8,128.31	$15,488.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $724.44 / $1,071.52	Professional		$457.09	$724.44	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $10,232.93 / $16,595.87	Facility		$1,862.09	$10,232.93	$16,595.87
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $645.65 / $1,288.25	Professional		$398.11	$645.65	$1,288.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $588.84 / $831.76	Professional		$323.59	$588.84	$831.76