Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $10,232.93 / $28,183.83	Facility		$2,398.83	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,819.70 / $2,511.89	Professional		$691.83	$1,819.70	$2,511.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,995.26 / $10,000.00	Facility		$707.95	$1,995.26	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,818.38	Professional		$2,344.23	$2,344.23	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $7,244.36 / $29,512.09	Facility		$4,365.16	$7,244.36	$29,512.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $6,606.93 / $9,549.93	Professional		$4,265.80	$6,606.93	$9,549.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $64.57	Professional		$33.11	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $1,348.96 / $5,754.40	Facility		$239.88	$1,348.96	$5,754.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $3,090.30	Facility		$2,754.23	$2,754.23	$3,090.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,265.80 / $5,754.40	Professional		$2,754.23	$4,265.80	$5,754.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $20,417.38 / $38,904.51	Facility		$13,803.84	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,801.89 / $5,248.07	Professional		$3,019.95	$3,801.89	$5,248.07
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $21,379.62 / $41,686.94	Facility		$2,454.71	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $2,884.03 / $5,248.07	Professional		$912.01	$2,884.03	$5,248.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $549.54 / $2,089.30	Professional		$288.40	$549.54	$2,089.30