Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,174.90 / $1,412.54	Facility		$707.95	$1,174.90	$1,412.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $870.96	Professional		$691.83	$691.83	$870.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $691.83 / $691.83	Facility		$645.65	$691.83	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $776.25	Professional		$691.83	$691.83	$776.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $1,737.80	Facility		$691.83	$691.83	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $1,380.38	Professional		$691.83	$691.83	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $79.43	Professional		$30.20	$60.26	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $691.83 / $1,023.29	Facility		$602.56	$691.83	$1,023.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $724.44 / $1,698.24	Facility		$549.54	$724.44	$1,698.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $831.76	Professional		$724.44	$724.44	$831.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $758.58 / $1,778.28	Facility		$602.56	$758.58	$1,778.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $758.58 / $758.58	Professional		$691.83	$758.58	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $758.58	Professional		$691.83	$691.83	$758.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $691.83 / $891.25	Professional		$645.65	$691.83	$891.25