Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $2,691.53 / $6,025.60	Facility		$562.34	$2,691.53	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $478.63 / $724.44	Professional		$208.93	$478.63	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,318.26 / $1,548.82	Facility		$630.96	$1,318.26	$1,548.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $602.56 / $2,754.23	Facility		$537.03	$602.56	$2,754.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $602.56 / $1,023.29	Professional		$478.63	$602.56	$1,023.29
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 $537.03 / $660.69 / $1,047.13	Facility		$537.03	$660.69	$1,047.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,047.13 / $1,819.70	Facility		$602.56	$1,047.13	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $724.44	Professional		$537.03	$537.03	$724.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $891.25 / $1,584.89	Facility		$630.96	$891.25	$1,584.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $537.03 / $676.08	Professional		$512.86	$537.03	$676.08
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $724.44 / $724.44	Facility		$602.56	$724.44	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $602.56	Professional		$125.89	$181.97	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $602.56 / $1,071.52	Professional		$269.15	$602.56	$1,071.52