Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $1,318.26	Facility		$562.34	$562.34	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $457.09 / $891.25	Professional		$354.81	$457.09	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $501.19	Professional		$363.08	$363.08	$501.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,148.15 / $2,454.71	Facility		$489.78	$1,148.15	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $1,023.29 / $1,778.28	Professional		$489.78	$1,023.29	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $660.69 / $724.44	Professional		$75.86	$660.69	$724.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $776.25 / $870.96	Facility		$691.83	$776.25	$870.96
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $870.96 / $870.96	Professional		$776.25	$870.96	$870.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,258.93 / $1,862.09	Facility		$758.58	$1,258.93	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $954.99	Professional		$724.44	$724.44	$954.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $741.31 / $977.24	Professional		$707.95	$741.31	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $1,258.93 / $1,258.93	Facility		$389.05	$1,258.93	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $512.86 / $724.44	Professional		$363.08	$512.86	$724.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $616.60 / $1,318.26	Professional		$467.74	$616.60	$1,318.26