Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $7,762.47 / $20,892.96	Facility		$1,778.28	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,023.29 / $2,290.87	Professional		$794.33	$1,023.29	$2,290.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,122.02 / $2,818.38	Facility		$645.65	$1,122.02	$2,818.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $2,818.38	Professional		$1,071.52	$1,445.44	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,041.74 / $8,128.31	Facility		$1,288.25	$2,041.74	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,949.84 / $2,754.23	Professional		$1,288.25	$1,949.84	$2,754.23
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 $1,318.26 / $1,778.28 / $1,862.09	Facility		$1,318.26	$1,778.28	$1,862.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,288.25	Facility		$1,258.93	$1,258.93	$1,288.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,089.30 / $2,754.23	Professional		$1,288.25	$2,089.30	$2,754.23
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 $1,071.52 / $1,737.80 / $2,398.83	Professional		$1,071.52	$1,737.80	$2,398.83
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 $977.24 / $1,318.26 / $2,691.53	Professional		$977.24	$1,318.26	$2,691.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $977.24 / $1,621.81	Professional		$851.14	$977.24	$1,621.81