Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $1,000.00	Facility		$416.87	$416.87	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $309.03 / $549.54	Professional		$251.19	$309.03	$549.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $316.23	Professional		$234.42	$234.42	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $741.31 / $1,778.28	Facility		$316.23	$741.31	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $724.44 / $1,230.27	Professional		$316.23	$724.44	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $478.63 / $524.81	Professional		$75.86	$478.63	$524.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $501.19 / $616.60	Facility		$489.78	$501.19	$616.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $616.60 / $616.60	Professional		$501.19	$616.60	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $912.01 / $1,348.96	Facility		$549.54	$912.01	$1,348.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $691.83	Professional		$512.86	$512.86	$691.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $537.03 / $691.83	Professional		$512.86	$537.03	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $812.83 / $812.83	Facility		$251.19	$812.83	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $269.15 / $478.63	Professional		$234.42	$269.15	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $537.03 / $954.99	Professional		$446.68	$537.03	$954.99