Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $933.25 / $3,311.31	Facility		$501.19	$933.25	$3,311.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $1,096.48	Professional		$331.13	$467.74	$1,096.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,148.15 / $1,659.59	Facility		$524.81	$1,148.15	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $575.44 / $758.58	Professional		$263.03	$575.44	$758.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $616.60 / $1,548.82	Facility		$501.19	$616.60	$1,548.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $630.96 / $1,380.38	Professional		$501.19	$630.96	$1,380.38
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 $501.19 / $501.19 / $954.99	Facility		$501.19	$501.19	$954.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $891.25 / $1,513.56	Facility		$501.19	$891.25	$1,513.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $602.56	Professional		$446.68	$446.68	$602.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $741.31 / $1,380.38	Facility		$524.81	$741.31	$1,380.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $446.68 / $602.56	Professional		$426.58	$446.68	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $602.56 / $602.56	Facility		$501.19	$602.56	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $562.34	Professional		$208.93	$208.93	$562.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $501.19 / $891.25	Professional		$223.87	$501.19	$891.25