Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $3,090.30 / $6,918.31	Facility		$645.65	$3,090.30	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $549.54 / $831.76	Professional		$416.87	$549.54	$831.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,513.56 / $1,778.28	Facility		$724.44	$1,513.56	$1,778.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $691.83 / $3,162.28	Facility		$616.60	$691.83	$3,162.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $691.83 / $1,174.90	Professional		$549.54	$691.83	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $758.58 / $1,202.26	Facility		$616.60	$758.58	$1,202.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,202.26 / $2,089.30	Facility		$691.83	$1,202.26	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $831.76	Professional		$616.60	$616.60	$831.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,047.13 / $1,819.70	Facility		$724.44	$1,047.13	$1,819.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $616.60 / $776.25	Professional		$588.84	$616.60	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $831.76 / $831.76	Facility		$691.83	$831.76	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $776.25	Professional		$288.40	$288.40	$776.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $691.83 / $1,230.27	Professional		$309.03	$691.83	$1,230.27