Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,445.44 / $3,981.07	Facility		$616.60	$1,445.44	$3,981.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $602.56 / $616.60	Professional		$575.44	$602.56	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $1,230.27	Facility		$616.60	$616.60	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,621.81 / $3,090.30	Facility		$794.33	$1,621.81	$3,090.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,548.82 / $2,137.96	Professional		$794.33	$1,548.82	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $758.58	Professional		$32.36	$33.11	$758.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $1,412.54	Facility		$676.08	$676.08	$1,412.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $724.44	Professional		$676.08	$676.08	$724.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $891.25 / $954.99	Professional		$676.08	$891.25	$954.99