Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $11,748.98 / $21,877.62	Facility		$1,778.28	$11,748.98	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $616.60	Professional		$158.49	$234.42	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility		$4,677.35	$4,677.35	$4,677.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $10,000.00 / $15,848.93	Facility		$3,019.95	$10,000.00	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $4,365.16 / $6,025.60	Professional		$2,454.71	$4,365.16	$6,025.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $60.26	Professional		$44.67	$50.12	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $2,344.23 / $3,548.13	Facility		$331.13	$2,344.23	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $870.96	Facility		$302.00	$302.00	$870.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $870.96 / $1,862.09	Professional		$380.19	$870.96	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,128.31 / $11,220.18 / $21,379.62	Facility		$8,128.31	$11,220.18	$21,379.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,230.27 / $1,698.24	Professional		$309.03	$1,230.27	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $13,182.57 / $22,387.21	Facility		$3,311.31	$13,182.57	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $389.05 / $1,659.59	Professional		$288.40	$389.05	$1,659.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $489.78 / $691.83	Professional		$416.87	$489.78	$691.83