Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,412.54 / $4,466.84	Facility		$912.01	$1,412.54	$4,466.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $691.83 / $1,479.11	Professional		$426.58	$691.83	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,621.81 / $1,995.26	Facility		$794.33	$1,621.81	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $794.33 / $1,047.13	Professional		$288.40	$794.33	$1,047.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $954.99 / $2,630.27	Facility		$758.58	$954.99	$2,630.27
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 / $676.08 / $812.83	Professional		$75.86	$676.08	$812.83
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 $691.83 / $691.83 / $912.01	Professional		$691.83	$691.83	$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 / $851.14	Professional		$645.65	$676.08	$851.14
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 $251.19 / $316.23 / $851.14	Professional		$251.19	$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