Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $14,791.08 / $25,703.96	Facility		$2,570.40	$14,791.08	$25,703.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,096.48 / $1,380.38	Professional		$831.76	$1,096.48	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $891.25	Professional		$741.31	$741.31	$891.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $21,379.62 / $60,255.96	Facility		$12,882.50	$21,379.62	$60,255.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12,302.69 / $19,054.61 / $28,183.83	Professional		$12,302.69	$19,054.61	$28,183.83
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 $1,348.96 / $1,737.80 / $2,238.72	Facility		$1,348.96	$1,737.80	$2,238.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,548.82	Facility		$1,445.44	$1,445.44	$1,548.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,238.72 / $3,235.94	Professional		$1,548.82	$2,238.72	$3,235.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $28,183.83 / $36,307.81 / $70,794.58	Facility		$28,183.83	$36,307.81	$70,794.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,041.74 / $2,754.23	Professional		$1,479.11	$2,041.74	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $38,018.94 / $72,443.60	Facility		$4,265.80	$38,018.94	$72,443.60
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,698.24 / $3,235.94	Professional		$977.24	$1,698.24	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.02	Professional		$0.02	$0.02	$0.02