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 $977.24 / $1,318.26 / $1,445.44	Professional		$977.24	$1,318.26	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $1,995.26	Facility		$707.95	$870.96	$1,995.26
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 $5,623.41 / $8,709.64 / $29,512.09	Facility		$5,623.41	$8,709.64	$29,512.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $8,317.64 / $12,022.64	Professional		$5,370.32	$8,317.64	$12,022.64
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 $1,698.24 / $2,398.83 / $3,715.35	Facility		$1,698.24	$2,398.83	$3,715.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,819.70	Facility		$1,698.24	$1,698.24	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,691.53 / $3,630.78	Professional		$1,819.70	$2,691.53	$3,630.78
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 $1,737.80 / $2,398.83 / $3,311.31	Professional		$1,737.80	$2,398.83	$3,311.31
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 $1,148.15 / $1,995.26 / $3,981.07	Professional		$1,148.15	$1,995.26	$3,981.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.02	Professional		$0.02	$0.02	$0.02