Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $6,025.60 / $18,620.87	Facility		$794.33	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $1,071.52	Professional		$363.08	$457.09	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $1,819.70	Facility		$630.96	$758.58	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $1,288.25	Professional		$398.11	$660.69	$1,288.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $870.96 / $1,548.82	Facility		$467.74	$870.96	$1,548.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $776.25 / $1,174.90	Professional		$398.11	$776.25	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $190.55	Professional		$32.36	$33.11	$190.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $776.25 / $851.14	Facility		$588.84	$776.25	$851.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $588.84 / $912.01	Facility		$575.44	$588.84	$912.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $912.01 / $1,258.93	Professional		$588.84	$912.01	$1,258.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,467.37 / $6,456.54	Facility		$2,570.40	$3,467.37	$6,456.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $812.83 / $1,071.52	Professional		$602.56	$812.83	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $3,715.35 / $7,079.46	Facility		$933.25	$3,715.35	$7,079.46
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $1,071.52	Professional		$398.11	$575.44	$1,071.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $478.63 / $794.33	Professional		$416.87	$478.63	$794.33