Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $17,782.79 / $28,183.83	Facility		$2,818.38	$17,782.79	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $2,290.87	Professional		$1,174.90	$1,659.59	$2,290.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Professional		$3,019.95	$3,019.95	$3,019.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616,595.00 / $616,595.00 / $616,595.00	Facility		$616,595.00	$616,595.00	$616,595.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $5,754.40 / $5,754.40	Professional		$5,754.40	$5,754.40	$5,754.40
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 $2,089.30 / $2,951.21 / $6,165.95	Facility		$2,089.30	$2,951.21	$6,165.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,778.28 / $2,630.27	Facility		$1,737.80	$1,778.28	$2,630.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $4,265.80 / $5,248.07	Professional		$2,630.27	$4,265.80	$5,248.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,884.03 / $6,309.57	Facility		$2,398.83	$2,884.03	$6,309.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,467.37 / $5,128.61	Professional		$2,290.87	$3,467.37	$5,128.61
United Facility/Professional Facility Modifier Low / Median / High Price $14,791.08 / $21,877.62 / $57,543.99	Facility		$14,791.08	$21,877.62	$57,543.99
United Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,884.03 / $5,370.32	Professional		$2,041.74	$2,884.03	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Professional		$1,548.82	$1,548.82	$1,548.82