Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $831.76 / $3,715.35	Facility		$524.81	$831.76	$3,715.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $1,023.29	Professional		$338.84	$478.63	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,202.26 / $1,348.96	Facility		$537.03	$1,202.26	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $602.56 / $741.31	Professional		$275.42	$602.56	$741.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $645.65 / $1,621.81	Facility		$524.81	$645.65	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $645.65 / $1,445.44	Professional		$524.81	$645.65	$1,445.44
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 $524.81 / $524.81 / $977.24	Facility		$524.81	$524.81	$977.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $912.01 / $1,548.82	Facility		$524.81	$912.01	$1,548.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $630.96	Professional		$467.74	$467.74	$630.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $776.25 / $1,445.44	Facility		$549.54	$776.25	$1,445.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $467.74 / $630.96	Professional		$446.68	$467.74	$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 $218.78 / $218.78 / $588.84	Professional		$218.78	$218.78	$588.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $524.81 / $933.25	Professional		$234.42	$524.81	$933.25