Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $7,762.47 / $20,892.96	Facility		$1,202.26	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $676.08 / $1,548.82	Professional		$512.86	$676.08	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,096.48 / $1,659.59	Facility		$645.65	$1,096.48	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,000.00 / $1,905.46	Professional		$676.08	$1,000.00	$1,905.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,318.26 / $6,025.60	Facility		$794.33	$1,318.26	$6,025.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,258.93 / $1,778.28	Professional		$794.33	$1,258.93	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,174.90 / $1,288.25	Facility		$831.76	$1,174.90	$1,288.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $851.14 / $870.96	Facility		$758.58	$851.14	$870.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,412.54 / $1,862.09	Professional		$870.96	$1,412.54	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $4,677.35 / $8,709.64	Facility		$3,548.13	$4,677.35	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,174.90 / $1,621.81	Professional		$741.31	$1,174.90	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $5,888.44 / $11,220.18	Facility		$1,862.09	$5,888.44	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $870.96 / $1,778.28	Professional		$630.96	$870.96	$1,778.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $691.83 / $1,122.02	Professional		$588.84	$691.83	$1,122.02