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 / $3,388.44	Facility		$588.84	$1,096.48	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $537.03 / $1,148.15	Professional		$389.05	$537.03	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,348.96 / $1,862.09	Facility		$602.56	$1,348.96	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $616.60 / $794.33	Professional		$338.84	$616.60	$794.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $851.14 / $1,995.26	Facility		$588.84	$851.14	$1,995.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $831.76 / $1,778.28	Professional		$588.84	$831.76	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $512.86 / $616.60	Professional		$75.86	$512.86	$616.60
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 / $707.95	Professional		$501.19	$524.81	$707.95
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 / $302.00 / $707.95	Professional		$245.47	$302.00	$707.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $588.84 / $1,047.13	Professional		$263.03	$588.84	$1,047.13