Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $776.25	Facility		$323.59	$323.59	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $302.00 / $501.19	Professional		$229.09	$302.00	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $338.84	Professional		$251.19	$251.19	$338.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $741.31 / $1,445.44	Facility		$316.23	$741.31	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $645.65 / $1,174.90	Professional		$316.23	$645.65	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $389.05 / $426.58	Professional		$75.86	$389.05	$426.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $489.78 / $602.56	Facility		$398.11	$489.78	$602.56
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $602.56	Professional		$446.68	$501.19	$602.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $741.31 / $1,071.52	Facility		$436.52	$741.31	$1,071.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $562.34	Professional		$416.87	$416.87	$562.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $562.34	Professional		$436.52	$436.52	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $812.83 / $812.83	Facility		$302.00	$812.83	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $338.84 / $478.63	Professional		$234.42	$338.84	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $436.52 / $776.25	Professional		$354.81	$436.52	$776.25