Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $2,137.96 / $5,370.32	Facility		$912.01	$2,137.96	$5,370.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $870.96 / $912.01	Professional		$851.14	$870.96	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $1,819.70	Facility		$912.01	$912.01	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Professional		$912.01	$912.01	$912.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $426.58 / $562.34	Facility		$234.42	$426.58	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $562.34	Professional		$295.12	$426.58	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,122.02	Professional		$32.36	$33.11	$1,122.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional		$1,000.00	$1,000.00	$1,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional		$1,000.00	$1,000.00	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $1,071.52	Professional		$891.25	$891.25	$1,071.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $660.69 / $1,318.26	Professional		$630.96	$660.69	$1,318.26