Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $7,943.28 / $20,892.96	Facility		$2,818.38	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,137.96 / $4,466.84	Professional		$1,659.59	$2,137.96	$4,466.84
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 $1,737.80 / $2,951.21 / $5,495.41	Professional		$1,737.80	$2,951.21	$5,495.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,630.78 / $10,000.00	Facility		$1,995.26	$3,630.78	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,548.13 / $6,606.93	Professional		$1,995.26	$3,548.13	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,548.13 / $3,890.45	Facility		$2,884.03	$3,548.13	$3,890.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,454.71	Facility		$2,398.83	$2,398.83	$2,454.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,801.89 / $5,128.61	Professional		$2,454.71	$3,801.89	$5,128.61
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 $2,454.71 / $3,388.44 / $4,570.88	Professional		$2,454.71	$3,388.44	$4,570.88
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 $1,905.46 / $2,818.38 / $5,011.87	Professional		$1,905.46	$2,818.38	$5,011.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,778.28 / $2,951.21	Professional		$1,548.82	$1,778.28	$2,951.21