Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $812.83 / $6,456.54	Facility		$416.87	$812.83	$6,456.54
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $831.76 / $1,071.52 / $1,071.52	Facility	54	$831.76	$1,071.52	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $380.19 / $794.33	Professional		$269.15	$380.19	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $467.74 / $562.34	Facility		$302.00	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $537.03 / $1,047.13	Professional		$295.12	$537.03	$1,047.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $426.58 / $812.83	Facility		$245.47	$426.58	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $436.52 / $794.33	Professional		$251.19	$436.52	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $275.42	Professional		$32.36	$33.11	$275.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $602.56 / $691.83	Facility		$436.52	$602.56	$691.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $446.68 / $478.63	Facility		$234.42	$446.68	$478.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $676.08 / $912.01	Professional		$436.52	$676.08	$912.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $660.69 / $1,288.25	Facility		$436.52	$660.69	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $602.56 / $812.83	Professional		$407.38	$602.56	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $912.01 / $1,949.84	Facility		$416.87	$912.01	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $457.09 / $870.96	Professional		$323.59	$457.09	$870.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $501.19 / $707.95	Professional		$371.54	$501.19	$707.95