Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $10,232.93 / $21,877.62	Facility		$707.95	$10,232.93	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $691.83 / $977.24	Professional		$489.78	$691.83	$977.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $707.95 / $954.99	Facility		$501.19	$707.95	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,230.27 / $1,819.70	Facility		$724.44	$1,230.27	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,122.02 / $1,778.28	Professional		$660.69	$1,122.02	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,348.96 / $1,513.56	Facility		$1,148.15	$1,348.96	$1,513.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,047.13	Facility		$1,023.29	$1,023.29	$1,047.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,548.82 / $2,238.72	Professional		$1,047.13	$1,548.82	$2,238.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,348.96 / $1,819.70	Professional		$1,047.13	$1,348.96	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,258.93 / $5,754.40	Facility		$707.95	$1,258.93	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $977.24 / $1,819.70	Professional		$660.69	$977.24	$1,819.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $812.83 / $1,348.96	Professional		$707.95	$812.83	$1,348.96