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 $1,737.80 / $2,344.23 / $5,011.87	Professional		$1,737.80	$2,344.23	$5,011.87
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 $1,862.09 / $3,162.28 / $5,888.44	Professional		$1,862.09	$3,162.28	$5,888.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $3,981.07 / $10,000.00	Facility		$2,089.30	$3,981.07	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,890.45 / $6,760.83	Professional		$2,089.30	$3,890.45	$6,760.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $123.03	Professional		$32.36	$33.11	$123.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,715.35 / $3,890.45	Facility		$3,090.30	$3,715.35	$3,890.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,691.53	Facility		$2,630.27	$2,630.27	$2,691.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $4,168.69 / $5,495.41	Professional		$2,691.53	$4,168.69	$5,495.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,481.54 / $15,135.61 / $28,840.32	Facility		$11,481.54	$15,135.61	$28,840.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,715.35 / $4,897.79	Professional		$2,630.27	$3,715.35	$4,897.79
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 $2,041.74 / $2,951.21 / $5,370.32	Professional		$2,041.74	$2,951.21	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,949.84 / $3,162.28	Professional		$1,659.59	$1,949.84	$3,162.28