Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,248.07 / $20,892.96	Facility		$2,818.38	$5,248.07	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,344.23 / $5,248.07	Professional		$1,862.09	$2,344.23	$5,248.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $870.96	Facility		$758.58	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,311.31 / $6,165.95	Professional		$2,041.74	$3,311.31	$6,165.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,754.23 / $5,248.07	Facility		$1,819.70	$2,754.23	$5,248.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,754.23 / $5,011.87	Professional		$1,778.28	$2,754.23	$5,011.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,981.07 / $4,168.69	Facility		$3,235.94	$3,981.07	$4,168.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,818.38	Facility		$2,754.23	$2,754.23	$2,818.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $4,365.16 / $5,888.44	Professional		$2,818.38	$4,365.16	$5,888.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,125.38 / $18,620.87 / $35,481.34	Facility		$14,125.38	$18,620.87	$35,481.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $3,890.45 / $5,248.07	Professional		$2,818.38	$3,890.45	$5,248.07
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $6,025.60 / $12,882.50	Facility		$4,265.80	$6,025.60	$12,882.50
United Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,162.28 / $5,623.41	Professional		$2,089.30	$3,162.28	$5,623.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,089.30 / $3,467.37	Professional		$1,819.70	$2,089.30	$3,467.37