Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $2,398.83	Facility		$794.33	$794.33	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $794.33 / $794.33	Professional		$426.58	$794.33	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,445.44 / $2,238.72	Facility		$501.19	$1,445.44	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $100.00	Professional		$50.12	$75.86	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,202.26 / $1,202.26	Facility		$467.74	$1,202.26	$1,202.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $2,691.53	Facility		$1,071.52	$1,445.44	$2,691.53
United Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,905.46 / $3,388.44	Facility		$1,412.54	$1,905.46	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $436.52 / $630.96	Professional		$295.12	$436.52	$630.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $977.24	Professional		$239.88	$239.88	$977.24