Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $758.58 / $954.99	Facility		$398.11	$758.58	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $371.54 / $676.08	Professional		$263.03	$371.54	$676.08
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 $389.05 / $912.01 / $1,778.28	Facility		$389.05	$912.01	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $776.25 / $1,412.54	Professional		$389.05	$776.25	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $467.74 / $512.86	Professional		$75.86	$467.74	$512.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $602.56 / $616.60	Facility		$489.78	$602.56	$616.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $616.60 / $616.60	Professional		$549.54	$616.60	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $891.25 / $1,318.26	Facility		$537.03	$891.25	$1,318.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $707.95	Professional		$512.86	$512.86	$707.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $537.03 / $691.83	Professional		$501.19	$537.03	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,000.00 / $1,000.00	Facility		$407.38	$1,000.00	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $588.84	Professional		$288.40	$407.38	$588.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $537.03 / $933.25	Professional		$436.52	$537.03	$933.25