Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $776.25 / $1,122.02	Facility		$524.81	$776.25	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $1,096.48	Professional		$371.54	$478.63	$1,096.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,479.11 / $2,570.40	Facility		$524.81	$1,479.11	$2,570.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $741.31 / $1,288.25	Professional		$389.05	$741.31	$1,288.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $851.14 / $1,258.93	Facility		$489.78	$851.14	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $831.76 / $1,096.48	Professional		$478.63	$831.76	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $154.88	Professional		$32.36	$33.11	$154.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $741.31 / $1,096.48	Facility		$616.60	$741.31	$1,096.48
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $537.03 / $537.03	Facility		$524.81	$537.03	$537.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $870.96 / $1,148.15	Professional		$524.81	$870.96	$1,148.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,513.56 / $3,019.95	Facility		$1,000.00	$1,513.56	$3,019.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $812.83 / $1,096.48	Professional		$549.54	$812.83	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $2,041.74 / $3,715.35	Facility		$478.63	$2,041.74	$3,715.35
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $588.84 / $1,202.26	Professional		$380.19	$588.84	$1,202.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $457.09 / $758.58	Professional		$398.11	$457.09	$758.58