Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $7,943.28 / $21,877.62	Facility		$2,951.21	$7,943.28	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,819.70 / $4,365.16	Professional		$1,513.56	$1,819.70	$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 $1,584.89 / $2,754.23 / $5,128.61	Professional		$1,584.89	$2,754.23	$5,128.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,548.13 / $10,000.00	Facility		$1,737.80	$3,548.13	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $3,467.37 / $6,606.93	Professional		$1,737.80	$3,467.37	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,235.94 / $3,388.44	Facility		$2,344.23	$3,235.94	$3,388.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,344.23	Facility		$2,290.87	$2,290.87	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,630.78 / $4,897.79	Professional		$2,344.23	$3,630.78	$4,897.79
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 $2,344.23 / $3,235.94 / $4,365.16	Professional		$2,344.23	$3,235.94	$4,365.16
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 $1,659.59 / $2,511.89 / $4,677.35	Professional		$1,659.59	$2,511.89	$4,677.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,778.28 / $2,884.03	Professional		$1,548.82	$1,778.28	$2,884.03