Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,513.56 / $17,782.79	Facility		$489.78	$1,513.56	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $416.87 / $1,148.15	Professional		$204.17	$416.87	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $1,348.96	Facility		$630.96	$758.58	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $524.81 / $1,258.93	Professional		$245.47	$524.81	$1,258.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $501.19 / $1,174.90	Facility		$239.88	$501.19	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $501.19 / $1,122.02	Professional		$239.88	$501.19	$1,122.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $891.25 / $1,000.00	Facility		$630.96	$891.25	$1,000.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $645.65	Facility		$616.60	$616.60	$645.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $616.60 / $1,148.15	Professional		$309.03	$616.60	$1,148.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,570.40 / $4,897.79	Facility		$1,995.26	$2,570.40	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $616.60 / $1,122.02	Professional		$302.00	$616.60	$1,122.02
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $3,090.30 / $5,011.87	Facility		$891.25	$3,090.30	$5,011.87
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $549.54 / $1,202.26	Professional		$275.42	$549.54	$1,202.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $371.54 / $676.08	Professional		$194.98	$371.54	$676.08