Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $1,737.80	Facility		$724.44	$724.44	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $588.84 / $954.99	Professional		$436.52	$588.84	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $758.58	Professional		$549.54	$549.54	$758.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,445.44 / $3,090.30	Facility		$616.60	$1,445.44	$3,090.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,258.93 / $2,238.72	Professional		$616.60	$1,258.93	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $831.76 / $912.01	Professional		$75.86	$831.76	$912.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $977.24 / $1,071.52	Facility		$851.14	$977.24	$1,071.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,071.52 / $1,071.52	Professional		$977.24	$1,071.52	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,584.89 / $2,344.23	Facility		$954.99	$1,584.89	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $1,230.27	Professional		$891.25	$891.25	$1,230.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $933.25 / $1,202.26	Professional		$891.25	$933.25	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,584.89 / $1,584.89	Facility		$478.63	$1,584.89	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $524.81 / $933.25	Professional		$446.68	$524.81	$933.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $776.25 / $1,659.59	Professional		$588.84	$776.25	$1,659.59