Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $10,232.93 / $28,183.83	Facility		$288.40	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $794.33	Professional		$288.40	$288.40	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Facility		$1,148.15	$1,148.15	$1,148.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $2,238.72 / $3,890.45	Facility		$776.25	$2,238.72	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,071.52 / $1,202.26	Professional		$741.31	$1,071.52	$1,202.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,380.38 / $2,187.76	Facility		$602.56	$1,380.38	$2,187.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,570.40 / $4,897.79	Facility		$1,737.80	$2,570.40	$4,897.79
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $3,467.37 / $5,623.41	Facility		$1,096.48	$3,467.37	$5,623.41