Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $1,000.00	Facility		$426.58	$426.58	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $363.08 / $588.84	Professional		$288.40	$363.08	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $436.52	Professional		$316.23	$316.23	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $933.25 / $1,862.09	Facility		$380.19	$933.25	$1,862.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $831.76 / $1,380.38	Professional		$380.19	$831.76	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $501.19 / $549.54	Professional		$75.86	$501.19	$549.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $645.65 / $676.08	Facility		$524.81	$645.65	$676.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $676.08	Professional		$660.69	$660.69	$676.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $954.99 / $1,412.54	Facility		$575.44	$954.99	$1,412.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $724.44	Professional		$549.54	$549.54	$724.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $562.34 / $741.31	Professional		$537.03	$562.34	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $977.24 / $977.24	Facility		$398.11	$977.24	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $398.11 / $575.44	Professional		$281.84	$398.11	$575.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $1,000.00	Professional		$407.38	$467.74	$1,000.00