Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $977.24 / $3,467.37	Facility		$524.81	$977.24	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $489.78 / $1,023.29	Professional		$323.59	$489.78	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,071.52 / $1,380.38	Facility		$549.54	$1,071.52	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $616.60 / $812.83	Professional		$281.84	$616.60	$812.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $660.69 / $1,621.81	Facility		$524.81	$660.69	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $660.69 / $1,445.44	Professional		$524.81	$660.69	$1,445.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $467.74 / $562.34	Professional		$75.86	$467.74	$562.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $1,000.00	Facility		$524.81	$524.81	$1,000.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $933.25 / $1,584.89	Facility		$524.81	$933.25	$1,584.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $630.96	Professional		$478.63	$478.63	$630.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $794.33 / $1,445.44	Facility		$549.54	$794.33	$1,445.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $478.63 / $630.96	Professional		$446.68	$478.63	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $630.96 / $630.96	Facility		$524.81	$630.96	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $588.84	Professional		$223.87	$223.87	$588.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $524.81 / $954.99	Professional		$239.88	$524.81	$954.99