Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $1,230.27	Facility		$512.86	$512.86	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $741.31	Professional		$302.00	$426.58	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $457.09	Professional		$331.13	$331.13	$457.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,047.13 / $2,238.72	Facility		$446.68	$1,047.13	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $933.25 / $1,659.59	Professional		$446.68	$933.25	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $602.56 / $660.69	Professional		$75.86	$602.56	$660.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $776.25 / $954.99	Facility		$630.96	$776.25	$954.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $794.33 / $954.99	Professional		$707.95	$794.33	$954.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,148.15 / $1,698.24	Facility		$691.83	$1,148.15	$1,698.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $870.96	Professional		$660.69	$660.69	$870.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $691.83 / $891.25	Professional		$676.08	$691.83	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,148.15 / $1,148.15	Facility		$467.74	$1,148.15	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $676.08	Professional		$331.13	$478.63	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $691.83 / $1,202.26	Professional		$562.34	$691.83	$1,202.26