Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $6,025.60 / $18,620.87	Facility		$707.95	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $416.87 / $954.99	Professional		$331.13	$416.87	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $741.31 / $3,981.07	Facility		$630.96	$741.31	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $588.84 / $1,122.02	Professional		$363.08	$588.84	$1,122.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $794.33 / $3,388.44	Facility		$416.87	$794.33	$3,388.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $691.83 / $1,778.28	Professional		$354.81	$691.83	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $169.82	Professional		$32.36	$33.11	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $707.95 / $758.58	Facility		$575.44	$707.95	$758.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $524.81 / $1,995.26	Facility		$501.19	$524.81	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $812.83 / $1,122.02	Professional		$524.81	$812.83	$1,122.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $7,943.28 / $15,135.61	Facility		$5,370.32	$7,943.28	$15,135.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $724.44 / $954.99	Professional		$562.34	$724.44	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $8,709.64 / $15,488.17	Facility		$1,548.82	$8,709.64	$15,488.17
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $512.86 / $954.99	Professional		$354.81	$512.86	$954.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $426.58 / $707.95	Professional		$371.54	$426.58	$707.95