Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $812.83	Facility		$794.33	$794.33	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,187.76 / $3,467.37	Facility		$724.44	$2,187.76	$3,467.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $75.86	Professional		$60.26	$70.79	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $1,949.84 / $1,949.84	Facility		$288.40	$1,949.84	$1,949.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,290.87 / $4,365.16	Facility		$1,548.82	$2,290.87	$4,365.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,951.21 / $5,370.32	Facility		$2,238.72	$2,951.21	$5,370.32