Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $407.38	Professional		$257.04	$257.04	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $21,877.62 / $36,307.81	Facility		$5,248.07	$21,877.62	$36,307.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $33,884.42 / $37,153.52	Facility		$7,943.28	$33,884.42	$37,153.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $5,888.44 / $5,888.44	Professional		$5,888.44	$5,888.44	$5,888.44
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 $2,754.23 / $19,054.61 / $19,054.61	Facility		$2,754.23	$19,054.61	$19,054.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,848.93 / $21,877.62 / $42,657.95	Facility		$15,848.93	$21,877.62	$42,657.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $20,892.96 / $27,542.29 / $50,118.72	Facility		$20,892.96	$27,542.29	$50,118.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10