Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $6,606.93 / $21,877.62	Facility		$2,818.38	$6,606.93	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,819.70 / $4,897.79	Professional		$1,412.54	$1,819.70	$4,897.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $870.96	Facility		$758.58	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,511.89 / $4,677.35	Professional		$1,445.44	$2,511.89	$4,677.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,162.28 / $10,471.29	Facility		$1,584.89	$3,162.28	$10,471.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $6,918.31	Professional		$1,584.89	$3,090.30	$6,918.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $100.00	Professional		$32.36	$33.11	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,019.95 / $3,090.30	Facility		$2,238.72	$3,019.95	$3,090.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,311.31 / $4,466.84	Professional		$2,089.30	$3,311.31	$4,466.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $15,135.61 / $28,840.32	Facility		$10,964.78	$15,135.61	$28,840.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,951.21 / $3,890.45	Professional		$2,137.96	$2,951.21	$3,890.45
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $17,782.79 / $33,884.42	Facility		$3,467.37	$17,782.79	$33,884.42
United Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,290.87 / $4,265.80	Professional		$1,548.82	$2,290.87	$4,265.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,621.81 / $2,630.27	Professional		$1,412.54	$1,621.81	$2,630.27