Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $851.14	Facility		$363.08	$363.08	$851.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $467.74	Professional		$181.97	$251.19	$467.74
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 $263.03 / $263.03 / $363.08	Professional		$263.03	$263.03	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $645.65 / $1,584.89	Facility		$263.03	$645.65	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $616.60 / $1,023.29	Professional		$263.03	$616.60	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $426.58 / $467.74	Professional		$75.86	$426.58	$467.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $457.09 / $562.34	Facility		$446.68	$457.09	$562.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $562.34 / $562.34	Professional		$457.09	$562.34	$562.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $812.83 / $1,202.26	Facility		$489.78	$812.83	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $645.65	Professional		$457.09	$457.09	$645.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $478.63 / $630.96	Professional		$457.09	$478.63	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $676.08 / $676.08	Facility		$275.42	$676.08	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $281.84 / $398.11	Professional		$194.98	$281.84	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $398.11 / $851.14	Professional		$257.04	$398.11	$851.14