Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,737.80 / $20,892.96	Facility		$446.68	$1,737.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $660.69	Professional		$218.78	$275.42	$660.69
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 $251.19 / $407.38 / $707.95	Professional		$251.19	$407.38	$707.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $426.58 / $602.56	Facility		$239.88	$426.58	$602.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $380.19 / $602.56	Professional		$223.87	$380.19	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $95.50	Professional		$32.36	$33.11	$95.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $457.09 / $478.63	Facility		$398.11	$457.09	$478.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $331.13	Facility		$323.59	$323.59	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $512.86 / $707.95	Professional		$331.13	$512.86	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $467.74 / $602.56	Professional		$363.08	$467.74	$602.56
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 $229.09 / $346.74 / $616.60	Professional		$229.09	$346.74	$616.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $245.47 / $407.38	Professional		$213.80	$245.47	$407.38