Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,000.00 / $17,782.79	Facility		$660.69	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $389.05 / $912.01	Professional		$309.03	$389.05	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $2,398.83	Facility		$467.74	$562.34	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $1,122.02	Professional		$331.13	$588.84	$1,122.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $575.44 / $1,513.56	Facility		$331.13	$575.44	$1,513.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $575.44 / $1,071.52	Professional		$331.13	$575.44	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $691.83 / $758.58	Facility		$478.63	$691.83	$758.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $512.86 / $537.03	Facility		$489.78	$512.86	$537.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $758.58 / $1,000.00	Professional		$478.63	$758.58	$1,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $4,570.88 / $8,709.64	Facility		$2,951.21	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $676.08 / $891.25	Professional		$467.74	$676.08	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $4,897.79 / $9,120.11	Facility		$891.25	$4,897.79	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $954.99	Professional		$380.19	$512.86	$954.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $660.69	Professional		$354.81	$478.63	$660.69