Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $891.25	Facility		$380.19	$380.19	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $263.03 / $489.78	Professional		$186.21	$263.03	$489.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Facility		$363.08	$363.08	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $363.08	Professional		$269.15	$269.15	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $676.08 / $1,659.59	Facility		$275.42	$676.08	$1,659.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $645.65 / $1,071.52	Professional		$275.42	$645.65	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $446.68 / $489.78	Professional		$75.86	$446.68	$489.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $501.19 / $575.44	Facility		$457.09	$501.19	$575.44
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $575.44 / $575.44	Professional		$501.19	$575.44	$575.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $851.14 / $1,258.93	Facility		$512.86	$851.14	$1,258.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $630.96	Professional		$478.63	$478.63	$630.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $501.19 / $645.65	Professional		$478.63	$501.19	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $707.95 / $707.95	Facility		$223.87	$707.95	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $416.87	Professional		$204.17	$288.40	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $501.19 / $891.25	Professional		$416.87	$501.19	$891.25