Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $1,737.80	Facility		$741.31	$741.31	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $724.44 / $741.31	Professional		$691.83	$724.44	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $1,348.96	Facility		$741.31	$741.31	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Professional		$741.31	$741.31	$741.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,548.82 / $1,819.70	Facility		$831.76	$1,548.82	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,548.82 / $1,995.26	Professional		$1,047.13	$1,548.82	$1,995.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $79.43	Professional		$44.67	$50.12	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,380.38	Facility		$758.58	$758.58	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Professional		$831.76	$831.76	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $144.54 / $691.83	Professional		$85.11	$144.54	$691.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $912.01 / $1,071.52	Professional		$831.76	$912.01	$1,071.52