Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,659.59 / $2,398.83	Facility		$1,122.02	$1,659.59	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $933.25 / $2,187.76	Professional		$707.95	$933.25	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $912.01	Facility		$707.95	$758.58	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,630.27	Professional		$812.83	$1,380.38	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,318.26 / $2,238.72	Facility		$776.25	$1,318.26	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,318.26 / $2,089.30	Professional		$776.25	$1,318.26	$2,089.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $371.54	Professional		$32.36	$33.11	$371.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,737.80 / $1,905.46	Facility		$1,380.38	$1,737.80	$1,905.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,148.15 / $1,174.90	Facility		$794.33	$1,148.15	$1,174.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,659.59 / $2,187.76	Professional		$1,000.00	$1,659.59	$2,187.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $8,317.64	Facility		$3,311.31	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,445.44 / $2,041.74	Professional		$954.99	$1,445.44	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $5,370.32 / $8,912.51	Facility		$1,122.02	$5,370.32	$8,912.51
United Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,288.25 / $2,238.72	Professional		$870.96	$1,288.25	$2,238.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $933.25 / $1,318.26	Professional		$630.96	$933.25	$1,318.26