Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $4,168.69 / $17,782.79	Facility		$380.19	$4,168.69	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $1,318.26 / $3,548.13	Professional		$177.83	$1,318.26	$3,548.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $1,949.84 / $5,370.32	Professional		$275.42	$1,949.84	$5,370.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $537.03 / $4,677.35	Facility		$281.84	$537.03	$4,677.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $537.03 / $4,677.35	Professional		$309.03	$537.03	$4,677.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,467.37 / $3,715.35	Facility		$2,630.27	$3,467.37	$3,715.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,570.40	Facility		$2,454.71	$2,454.71	$2,570.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $616.60 / $4,897.79	Professional		$245.47	$616.60	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $562.34 / $4,466.84	Professional		$263.03	$562.34	$4,466.84
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $660.69 / $6,165.95	Facility		$190.55	$660.69	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $1,778.28 / $4,677.35	Professional		$239.88	$1,778.28	$4,677.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $302.00 / $2,630.27	Professional		$158.49	$302.00	$2,630.27