Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $7,762.47 / $20,892.96	Facility		$1,412.54	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $851.14 / $1,995.26	Professional		$660.69	$851.14	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $3,311.31	Facility		$707.95	$758.58	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,202.26 / $2,290.87	Professional		$707.95	$1,202.26	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,548.82 / $3,801.89	Facility		$741.31	$1,548.82	$3,801.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,445.44 / $2,570.40	Professional		$724.44	$1,445.44	$2,570.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,445.44 / $1,513.56	Facility		$1,096.48	$1,445.44	$1,513.56
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 / $2,187.76	Professional		$1,023.29	$1,584.89	$2,187.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,120.11 / $17,378.01	Facility		$5,888.44	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,412.54 / $1,905.46	Professional		$1,023.29	$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 / $1,122.02 / $2,089.30	Professional		$758.58	$1,122.02	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $794.33 / $1,318.26	Professional		$691.83	$794.33	$1,318.26