Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $6,456.54 / $22,387.21	Facility		$3,019.95	$6,456.54	$22,387.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,905.46 / $4,365.16	Professional		$1,479.11	$1,905.46	$4,365.16
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 $1,479.11 / $2,691.53 / $4,897.79	Professional		$1,479.11	$2,691.53	$4,897.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,311.31 / $10,000.00	Facility		$1,659.59	$3,311.31	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $3,235.94 / $6,606.93	Professional		$1,659.59	$3,235.94	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $3,162.28 / $3,235.94	Facility		$2,398.83	$3,162.28	$3,235.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility		$2,187.76	$2,187.76	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,388.44 / $4,677.35	Professional		$2,187.76	$3,388.44	$4,677.35
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 $2,187.76 / $3,090.30 / $4,073.80	Professional		$2,187.76	$3,090.30	$4,073.80
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 $1,737.80 / $2,454.71 / $4,466.84	Professional		$1,737.80	$2,454.71	$4,466.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,698.24 / $2,754.23	Professional		$1,479.11	$1,698.24	$2,754.23