Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $2,187.76 / $4,786.30	Facility		$457.09	$2,187.76	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $389.05 / $467.74	Professional		$144.54	$389.05	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $977.24 / $1,258.93	Facility		$501.19	$977.24	$1,258.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $478.63 / $2,238.72	Facility		$436.52	$478.63	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $478.63 / $812.83	Professional		$436.52	$478.63	$812.83
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 $436.52 / $478.63 / $724.44	Facility		$436.52	$478.63	$724.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $851.14 / $1,445.44	Facility		$478.63	$851.14	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $575.44	Professional		$436.52	$436.52	$575.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $724.44 / $1,288.25	Facility		$501.19	$724.44	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $436.52 / $537.03	Professional		$407.38	$436.52	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $575.44 / $575.44	Facility		$478.63	$575.44	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $478.63	Professional		$87.10	$123.03	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $478.63 / $870.96	Professional		$218.78	$478.63	$870.96