Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,995.26 / $5,128.61	Facility		$676.08	$1,995.26	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $575.44 / $691.83	Professional		$295.12	$575.44	$691.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,584.89 / $1,862.09	Facility		$741.31	$1,584.89	$1,862.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $724.44 / $3,311.31	Facility		$645.65	$724.44	$3,311.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $1,230.27	Professional		$575.44	$724.44	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $794.33 / $1,258.93	Facility		$645.65	$794.33	$1,258.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,258.93 / $2,137.96	Facility		$724.44	$1,258.93	$2,137.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $870.96	Professional		$645.65	$645.65	$870.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,071.52 / $1,995.26	Facility		$758.58	$1,071.52	$1,995.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $645.65 / $812.83	Professional		$616.60	$645.65	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $870.96 / $870.96	Facility		$724.44	$870.96	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $812.83	Professional		$302.00	$302.00	$812.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $724.44 / $1,288.25	Professional		$323.59	$724.44	$1,288.25