Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $1,122.02	Facility		$478.63	$478.63	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $691.83	Professional		$309.03	$436.52	$691.83
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 $457.09 / $1,096.48 / $2,089.30	Facility		$457.09	$1,096.48	$2,089.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $933.25 / $1,698.24	Professional		$457.09	$933.25	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $562.34 / $616.60	Professional		$75.86	$562.34	$616.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $707.95 / $724.44	Facility		$575.44	$707.95	$724.44
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $724.44 / $724.44	Professional		$660.69	$724.44	$724.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,071.52 / $1,584.89	Facility		$645.65	$1,071.52	$1,584.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $831.76	Professional		$602.56	$602.56	$831.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $630.96 / $812.83	Professional		$602.56	$630.96	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,202.26 / $1,202.26	Facility		$446.68	$1,202.26	$1,202.26
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $489.78 / $691.83	Professional		$346.74	$489.78	$691.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $630.96 / $1,122.02	Professional		$524.81	$630.96	$1,122.02