Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,737.80 / $20,892.96	Facility		$870.96	$1,737.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $512.86 / $1,230.27	Professional		$416.87	$512.86	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $707.95 / $954.99	Facility		$501.19	$707.95	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $724.44 / $1,380.38	Professional		$436.52	$724.44	$1,380.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $831.76 / $1,174.90	Facility		$457.09	$831.76	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $758.58 / $1,174.90	Professional		$436.52	$758.58	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $204.17	Professional		$32.36	$33.11	$204.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $891.25 / $912.01	Facility		$676.08	$891.25	$912.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $630.96	Facility		$602.56	$602.56	$630.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $977.24 / $1,348.96	Professional		$630.96	$977.24	$1,348.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $870.96 / $1,122.02	Professional		$691.83	$870.96	$1,122.02
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,258.93 / $5,754.40	Facility		$707.95	$1,258.93	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $630.96 / $1,148.15	Professional		$416.87	$630.96	$1,148.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $758.58	Professional		$407.38	$467.74	$758.58