Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $6,025.60 / $18,620.87	Facility		$1,412.54	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $851.14 / $1,995.26	Professional		$676.08	$851.14	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $3,981.07	Facility		$630.96	$758.58	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,202.26 / $2,290.87	Professional		$676.08	$1,202.26	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,513.56 / $3,801.89	Facility		$812.83	$1,513.56	$3,801.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,513.56 / $2,570.40	Professional		$741.31	$1,513.56	$2,570.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,445.44 / $1,479.11	Facility		$1,174.90	$1,445.44	$1,479.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,023.29	Facility		$1,000.00	$1,000.00	$1,023.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $2,137.96	Professional		$1,023.29	$1,584.89	$2,137.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $9,332.54 / $17,378.01	Facility		$6,918.31	$9,332.54	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $1,905.46	Professional		$1,000.00	$1,412.54	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $10,471.29 / $19,054.61	Facility		$1,995.26	$10,471.29	$19,054.61
United Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,096.48 / $2,041.74	Professional		$758.58	$1,096.48	$2,041.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $776.25 / $1,288.25	Professional		$676.08	$776.25	$1,288.25