Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $1,000.00	Professional		$549.54	$549.54	$1,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $549.54	Facility		$524.81	$524.81	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $676.08	Professional		$549.54	$549.54	$676.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $2,137.96 / $3,311.31	Facility		$380.19	$2,137.96	$3,311.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,511.89 / $4,365.16	Professional		$2,137.96	$2,511.89	$4,365.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $60.26	Professional		$39.81	$50.12	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $691.83 / $1,096.48	Facility		$549.54	$691.83	$1,096.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,951.21	Facility		$2,238.72	$2,238.72	$2,951.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $3,235.94	Professional		$2,951.21	$2,951.21	$3,235.94
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 / $2,691.53	Professional		$125.89	$151.36	$2,691.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04