Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $602.56	Professional		$251.19	$426.58	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $691.83 / $1,148.15	Facility		$371.54	$691.83	$1,148.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $691.83 / $1,258.93	Facility		$234.42	$691.83	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $64.57 / $75.86	Professional		$30.20	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $588.84 / $588.84	Facility		$173.78	$588.84	$588.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $724.44 / $1,318.26	Facility		$524.81	$724.44	$1,318.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $269.15	Professional		$120.23	$120.23	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $912.01 / $1,621.81	Facility		$676.08	$912.01	$1,621.81