Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $6,025.60 / $18,620.87	Facility		$870.96	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $549.54 / $1,288.25	Professional		$407.38	$549.54	$1,288.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $2,630.27	Facility		$630.96	$758.58	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $758.58 / $1,412.54	Professional		$446.68	$758.58	$1,412.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $954.99 / $2,454.71	Facility		$501.19	$954.99	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $933.25 / $1,621.81	Professional		$478.63	$933.25	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $208.93	Professional		$32.36	$33.11	$208.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $870.96 / $933.25	Facility		$660.69	$870.96	$933.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $630.96	Facility		$616.60	$616.60	$630.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $977.24 / $1,318.26	Professional		$630.96	$977.24	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $5,495.41 / $10,471.29	Facility		$3,890.45	$5,495.41	$10,471.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $870.96 / $1,174.90	Professional		$630.96	$870.96	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $6,760.83 / $11,220.18	Facility		$1,995.26	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $691.83 / $1,288.25	Professional		$467.74	$691.83	$1,288.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $501.19 / $831.76	Professional		$436.52	$501.19	$831.76