Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $1,071.52	Facility		$446.68	$446.68	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $616.60	Professional		$281.84	$363.08	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $380.19	Professional		$275.42	$275.42	$380.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $912.01 / $1,905.46	Facility		$380.19	$912.01	$1,905.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $794.33 / $1,412.54	Professional		$346.74	$794.33	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $676.08	Professional		$60.26	$75.86	$676.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $645.65 / $691.83	Facility		$524.81	$645.65	$691.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $691.83	Professional		$660.69	$660.69	$691.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $977.24 / $1,445.44	Facility		$588.84	$977.24	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $724.44	Professional		$549.54	$549.54	$724.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $575.44 / $741.31	Professional		$549.54	$575.44	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $1,000.00 / $1,000.00	Facility		$302.00	$1,000.00	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $331.13 / $575.44	Professional		$281.84	$331.13	$575.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $478.63 / $1,023.29	Professional		$363.08	$478.63	$1,023.29