Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,778.28 / $20,892.96	Facility		$1,202.26	$1,778.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $691.83 / $1,659.59	Professional		$575.44	$691.83	$1,659.59
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 $549.54 / $1,000.00 / $1,905.46	Professional		$549.54	$1,000.00	$1,905.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,148.15 / $1,621.81	Facility		$616.60	$1,148.15	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,023.29 / $1,584.89	Professional		$575.44	$1,023.29	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $281.84	Professional		$32.36	$33.11	$281.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,202.26 / $1,258.93	Facility		$1,023.29	$1,202.26	$1,258.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $870.96	Facility		$831.76	$831.76	$870.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,348.96 / $1,862.09	Professional		$870.96	$1,348.96	$1,862.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,202.26 / $1,548.82	Professional		$954.99	$1,202.26	$1,548.82
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 $575.44 / $870.96 / $1,584.89	Professional		$575.44	$870.96	$1,584.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $1,047.13	Professional		$562.34	$645.65	$1,047.13