Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,737.80 / $20,892.96	Facility		$812.83	$1,737.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $489.78 / $1,174.90	Professional		$398.11	$489.78	$1,174.90
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 / $691.83 / $1,288.25	Professional		$436.52	$691.83	$1,288.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $776.25 / $1,096.48	Facility		$436.52	$776.25	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $691.83 / $1,096.48	Professional		$407.38	$691.83	$1,096.48
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 $645.65 / $831.76 / $891.25	Facility		$645.65	$831.76	$891.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
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 Professional Modifier Low / Median / High Price $645.65 / $831.76 / $1,096.48	Professional		$645.65	$831.76	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $812.83 / $3,311.31	Facility		$794.33	$812.83	$3,311.31
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $616.60 / $1,096.48	Professional		$407.38	$616.60	$1,096.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $776.25	Professional		$407.38	$467.74	$776.25