Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,570.40 / $3,801.89	Facility		$1,737.80	$2,570.40	$3,801.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,479.11 / $3,235.94	Professional		$1,047.13	$1,479.11	$3,235.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $1,584.89	Facility		$707.95	$758.58	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,089.30 / $3,890.45	Professional		$1,230.27	$2,089.30	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $3,467.37	Facility		$1,202.26	$2,041.74	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $3,311.31	Professional		$1,202.26	$2,041.74	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $549.54	Professional		$32.36	$33.11	$549.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,691.53 / $3,019.95	Facility		$2,137.96	$2,691.53	$3,019.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,778.28 / $1,862.09	Facility		$1,412.54	$1,778.28	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,454.71 / $3,467.37	Professional		$1,479.11	$2,454.71	$3,467.37
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 $1,380.38 / $2,187.76 / $3,162.28	Professional		$1,380.38	$2,187.76	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $11,481.54 / $19,054.61	Facility		$3,467.37	$11,481.54	$19,054.61
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,949.84 / $3,467.37	Professional		$1,288.25	$1,949.84	$3,467.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,445.44 / $2,041.74	Professional		$912.01	$1,445.44	$2,041.74