Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $616.60 / $1,949.84	Facility		$309.03	$616.60	$1,949.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $288.40 / $645.65	Professional		$128.82	$288.40	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $707.95 / $851.14	Facility		$346.74	$707.95	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $371.54 / $467.74	Professional		$165.96	$371.54	$467.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $416.87 / $1,023.29	Facility		$331.13	$416.87	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $416.87 / $912.01	Professional		$331.13	$416.87	$912.01
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 $331.13 / $331.13 / $630.96	Facility		$331.13	$331.13	$630.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $575.44 / $1,000.00	Facility		$331.13	$575.44	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $398.11	Professional		$295.12	$295.12	$398.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $501.19 / $912.01	Facility		$346.74	$501.19	$912.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $295.12 / $371.54	Professional		$281.84	$295.12	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $398.11 / $398.11	Facility		$331.13	$398.11	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $138.04 / $371.54	Professional		$77.62	$138.04	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $331.13 / $602.56	Professional		$147.91	$331.13	$602.56