Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,737.80 / $17,782.79	Facility		$489.78	$1,737.80	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $537.03 / $1,230.27	Professional		$245.47	$537.03	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $676.08 / $1,513.56	Professional		$380.19	$676.08	$1,513.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $794.33 / $2,570.40	Facility		$389.05	$794.33	$2,570.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $676.08 / $1,548.82	Professional		$389.05	$676.08	$1,548.82
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 $660.69 / $1,000.00 / $1,071.52	Facility		$660.69	$1,000.00	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $741.31 / $1,412.54	Professional		$338.84	$741.31	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $5,754.40 / $10,964.78	Facility		$4,365.16	$5,754.40	$10,964.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $691.83 / $1,288.25	Professional		$371.54	$691.83	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $7,762.47 / $12,589.25	Facility		$1,995.26	$7,762.47	$12,589.25
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $645.65 / $1,348.96	Professional		$323.59	$645.65	$1,348.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $416.87 / $758.58	Professional		$218.78	$416.87	$758.58