Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $741.31 / $891.25	Professional		$724.44	$741.31	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,513.56	Facility		$758.58	$758.58	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,000.00 / $1,621.81	Facility		$478.63	$1,000.00	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $1,071.52 / $1,621.81	Professional		$478.63	$1,071.52	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $426.58 / $758.58	Facility		$309.03	$426.58	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $389.05	Facility		$346.74	$346.74	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26