Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $6,025.60 / $18,620.87	Facility		$933.25	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $588.84 / $1,380.38	Professional		$426.58	$588.84	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $1,548.82	Facility		$933.25	$933.25	$1,548.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $933.25 / $1,513.56	Professional		$524.81	$933.25	$1,513.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,096.48 / $4,168.69	Facility		$630.96	$1,096.48	$4,168.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,047.13 / $1,445.44	Professional		$602.56	$1,047.13	$1,445.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $891.25 / $1,000.00	Facility		$645.65	$891.25	$1,000.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $676.08	Facility		$660.69	$660.69	$676.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,122.02 / $1,412.54	Professional		$676.08	$1,122.02	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $8,317.64	Facility		$3,311.31	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $954.99 / $1,258.93	Professional		$676.08	$954.99	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,754.40 / $9,332.54	Facility		$1,698.24	$5,754.40	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $724.44 / $1,380.38	Professional		$457.09	$724.44	$1,380.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $630.96 / $891.25	Professional		$467.74	$630.96	$891.25