Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,096.48 / $3,801.89	Facility		$588.84	$1,096.48	$3,801.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $537.03 / $1,148.15	Professional		$380.19	$537.03	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,202.26 / $1,513.56	Facility		$588.84	$1,202.26	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $616.60 / $831.76	Professional		$281.84	$616.60	$831.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $724.44 / $2,630.27	Facility		$588.84	$724.44	$2,630.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $724.44 / $1,621.81	Professional		$588.84	$724.44	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $870.96	Facility		$588.84	$588.84	$870.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,023.29 / $1,737.80	Facility		$588.84	$1,023.29	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $707.95	Professional		$524.81	$524.81	$707.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $870.96 / $1,621.81	Facility		$616.60	$870.96	$1,621.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $524.81 / $660.69	Professional		$501.19	$524.81	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $707.95 / $707.95	Facility		$588.84	$707.95	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $660.69	Professional		$245.47	$245.47	$660.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $588.84 / $1,047.13	Professional		$263.03	$588.84	$1,047.13