Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $7,762.47 / $20,892.96	Facility		$1,318.26	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $1,862.09	Professional		$630.96	$794.33	$1,862.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $3,388.44	Facility		$707.95	$870.96	$3,388.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,096.48 / $2,137.96	Professional		$630.96	$1,096.48	$2,137.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,412.54 / $3,235.94	Facility		$676.08	$1,412.54	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,348.96 / $2,238.72	Professional		$676.08	$1,348.96	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $87.10	Professional		$32.36	$33.11	$87.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,348.96 / $1,412.54	Facility		$851.14	$1,348.96	$1,412.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $954.99	Facility		$933.25	$933.25	$954.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,479.11 / $2,041.74	Professional		$954.99	$1,479.11	$2,041.74
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 $954.99 / $1,318.26 / $1,778.28	Professional		$954.99	$1,318.26	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $8,511.38 / $16,595.87	Facility		$1,122.02	$8,511.38	$16,595.87
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,023.29 / $1,905.46	Professional		$616.60	$1,023.29	$1,905.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $741.31 / $1,230.27	Professional		$645.65	$741.31	$1,230.27