Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,019.95 / $6,760.83	Facility		$630.96	$3,019.95	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $549.54 / $831.76	Professional		$446.68	$549.54	$831.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,513.56 / $1,737.80	Facility		$707.95	$1,513.56	$1,737.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $676.08 / $3,162.28	Facility		$602.56	$676.08	$3,162.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $1,148.15	Professional		$537.03	$676.08	$1,148.15
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 $602.56 / $741.31 / $1,174.90	Facility		$602.56	$741.31	$1,174.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,174.90 / $2,041.74	Facility		$676.08	$1,174.90	$2,041.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $812.83	Professional		$602.56	$602.56	$812.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,023.29 / $1,862.09	Facility		$707.95	$1,023.29	$1,862.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $602.56 / $758.58	Professional		$575.44	$602.56	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $812.83 / $812.83	Facility		$676.08	$812.83	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $758.58	Professional		$281.84	$281.84	$758.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $676.08 / $1,230.27	Professional		$302.00	$676.08	$1,230.27