Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,862.09 / $5,495.41	Facility		$794.33	$1,862.09	$5,495.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $660.69 / $1,023.29	Professional		$467.74	$660.69	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $776.25	Professional		$562.34	$562.34	$776.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,548.82 / $3,388.44	Facility		$660.69	$1,548.82	$3,388.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,380.38 / $2,398.83	Professional		$660.69	$1,380.38	$2,398.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $812.83 / $1,000.00	Professional		$75.86	$812.83	$1,000.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,071.52 / $1,174.90	Facility		$933.25	$1,071.52	$1,174.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,174.90 / $1,174.90	Professional		$1,047.13	$1,174.90	$1,174.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,737.80 / $2,511.89	Facility		$1,023.29	$1,737.80	$2,511.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $977.24 / $1,348.96	Professional		$977.24	$977.24	$1,348.96
Regence BlueShield 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
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,023.29 / $1,318.26	Professional		$977.24	$1,023.29	$1,318.26
United Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,698.24 / $1,698.24	Facility		$512.86	$1,698.24	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $602.56 / $1,000.00	Professional		$489.78	$602.56	$1,000.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,023.29 / $1,819.70	Professional		$831.76	$1,023.29	$1,819.70