Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $724.44 / $741.31	Facility		$309.03	$724.44	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $316.23	Professional		$295.12	$302.00	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $616.60	Facility		$309.03	$309.03	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $794.33 / $1,230.27	Facility		$457.09	$794.33	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $851.14 / $1,148.15	Professional		$512.86	$851.14	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $812.83	Facility		$346.74	$346.74	$812.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $346.74 / $891.25	Facility		$47.86	$346.74	$891.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $363.08	Professional		$302.00	$302.00	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $446.68 / $489.78	Professional		$346.74	$446.68	$489.78