Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $5,011.87	Facility		$954.99	$954.99	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $954.99 / $1,819.70	Professional		$602.56	$954.99	$1,819.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,981.07 / $6,606.93	Facility		$2,137.96	$3,981.07	$6,606.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,862.09 / $5,888.44	Facility		$1,148.15	$1,862.09	$5,888.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,862.09 / $2,511.89	Professional		$1,148.15	$1,862.09	$2,511.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $630.96	Professional		$32.36	$33.11	$630.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $851.14 / $912.01	Facility		$831.76	$851.14	$912.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,258.93	Facility		$1,174.90	$1,174.90	$1,258.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,905.46 / $2,691.53	Professional		$1,258.93	$1,905.46	$2,691.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,890.45 / $7,762.47	Facility		$2,630.27	$3,890.45	$7,762.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $2,511.89	Professional		$1,318.26	$1,862.09	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $4,677.35 / $8,511.38	Facility		$3,548.13	$4,677.35	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,148.15 / $2,344.23	Professional		$812.83	$1,148.15	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,288.25 / $1,819.70	Professional		$954.99	$1,288.25	$1,819.70