Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $812.83	Professional		$660.69	$660.69	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $660.69	Facility		$616.60	$616.60	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $812.83	Professional		$660.69	$660.69	$812.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $741.31 / $1,122.02	Facility		$380.19	$741.31	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $870.96 / $1,621.81	Professional		$741.31	$870.96	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $75.86	Professional		$30.20	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $660.69 / $933.25	Facility		$389.05	$660.69	$933.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,380.38	Facility		$1,288.25	$1,288.25	$1,380.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,288.25 / $1,288.25	Professional		$1,258.93	$1,288.25	$1,288.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $131.83	Professional		$125.89	$125.89	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $1,659.59	Professional		$125.89	$151.36	$1,659.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04