Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,659.59 / $5,011.87	Facility		$758.58	$1,659.59	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $707.95 / $1,479.11	Professional		$501.19	$707.95	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,621.81 / $1,949.84	Facility		$794.33	$1,621.81	$1,949.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $891.25 / $1,071.52	Professional		$398.11	$891.25	$1,071.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $933.25 / $2,344.23	Facility		$758.58	$933.25	$2,344.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $954.99 / $2,089.30	Professional		$758.58	$954.99	$2,089.30
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 $758.58 / $758.58 / $1,445.44	Facility		$758.58	$758.58	$1,445.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,318.26 / $2,290.87	Facility		$758.58	$1,318.26	$2,290.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $912.01	Professional		$676.08	$676.08	$912.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,148.15 / $2,089.30	Facility		$794.33	$1,148.15	$2,089.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $676.08 / $912.01	Professional		$645.65	$676.08	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $912.01 / $912.01	Facility		$758.58	$912.01	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $851.14	Professional		$316.23	$316.23	$851.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $758.58 / $1,380.38	Professional		$338.84	$758.58	$1,380.38