Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $7,762.47 / $20,892.96	Facility		$1,659.59	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $954.99 / $2,187.76	Professional		$741.31	$954.99	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,122.02 / $1,862.09	Facility		$645.65	$1,122.02	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,380.38 / $2,630.27	Professional		$977.24	$1,380.38	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,905.46 / $8,128.31	Facility		$1,174.90	$1,905.46	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,819.70 / $2,691.53	Professional		$1,174.90	$1,819.70	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,698.24 / $1,778.28	Facility		$1,258.93	$1,698.24	$1,778.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,202.26	Facility		$1,174.90	$1,174.90	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,995.26 / $2,570.40	Professional		$1,202.26	$1,995.26	$2,570.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $8,128.31 / $15,488.17	Facility		$5,370.32	$8,128.31	$15,488.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,621.81 / $2,238.72	Professional		$1,023.29	$1,621.81	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $10,232.93 / $16,595.87	Facility		$1,862.09	$10,232.93	$16,595.87
United Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $2,511.89	Professional		$912.01	$1,230.27	$2,511.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $933.25 / $1,513.56	Professional		$812.83	$933.25	$1,513.56