Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,737.80 / $20,892.96	Facility		$891.25	$1,737.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $602.56 / $1,412.54	Professional		$478.63	$602.56	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $954.99 / $1,412.54	Professional		$616.60	$954.99	$1,412.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,023.29 / $1,258.93	Facility		$602.56	$1,023.29	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,023.29 / $1,258.93	Professional		$758.58	$1,023.29	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $912.01 / $977.24	Facility		$794.33	$912.01	$977.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,071.52 / $1,412.54	Professional		$660.69	$1,071.52	$1,412.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $933.25 / $1,258.93	Professional		$660.69	$933.25	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,311.31 / $37,153.52	Facility		$1,122.02	$3,311.31	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $758.58 / $1,348.96	Professional		$512.86	$758.58	$1,348.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $602.56 / $831.76	Professional		$512.86	$602.56	$831.76