Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $6,456.54 / $20,892.96	Facility		$1,737.80	$6,456.54	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $1,000.00	Professional		$281.84	$380.19	$1,000.00
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 $371.54 / $371.54 / $446.68	Professional		$371.54	$371.54	$446.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $8,128.31 / $8,128.31 / $8,128.31	Facility		$8,128.31	$8,128.31	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Professional		$1,230.27	$1,230.27	$1,230.27
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 $446.68 / $630.96 / $776.25	Facility		$446.68	$630.96	$776.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $524.81	Facility		$489.78	$489.78	$524.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $776.25 / $1,096.48	Professional		$524.81	$776.25	$1,096.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $5,370.32 / $6,760.83	Facility		$5,370.32	$5,370.32	$6,760.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $707.95 / $954.99	Professional		$501.19	$707.95	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $549.54 / $5,754.40	Facility		$158.49	$549.54	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $575.44 / $1,047.13	Professional		$363.08	$575.44	$1,047.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.02	Professional		$0.02	$0.02	$0.02