Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $831.76 / $1,122.02	Facility		$426.58	$831.76	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $1,071.52	Professional		$302.00	$426.58	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,659.59 / $2,754.23	Facility		$1,071.52	$1,659.59	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $831.76 / $1,348.96	Professional		$489.78	$831.76	$1,348.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $891.25 / $2,570.40	Facility		$524.81	$891.25	$2,570.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $870.96 / $1,148.15	Professional		$524.81	$870.96	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $758.58 / $851.14	Facility		$537.03	$758.58	$851.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $575.44	Facility		$549.54	$549.54	$575.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $933.25 / $1,230.27	Professional		$575.44	$933.25	$1,230.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,621.81 / $3,162.28	Facility		$1,071.52	$1,621.81	$3,162.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $870.96 / $1,174.90	Professional		$562.34	$870.96	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,089.30 / $3,801.89	Facility		$1,548.82	$2,089.30	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $512.86 / $1,071.52	Professional		$316.23	$512.86	$1,071.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $588.84 / $831.76	Professional		$436.52	$588.84	$831.76