Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $7,943.28 / $20,892.96	Facility		$3,235.94	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,090.30 / $6,760.83	Professional		$2,344.23	$3,090.30	$6,760.83
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 $2,454.71 / $4,168.69 / $7,762.47	Professional		$2,454.71	$4,168.69	$7,762.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $4,897.79 / $10,000.00	Facility		$2,754.23	$4,897.79	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,786.30 / $7,079.46	Professional		$2,754.23	$4,786.30	$7,079.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $162.18	Professional		$32.36	$33.11	$162.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $5,011.87 / $5,248.07	Facility		$4,265.80	$5,011.87	$5,248.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,548.13	Facility		$3,467.37	$3,467.37	$3,548.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $5,495.41 / $7,413.10	Professional		$3,548.13	$5,495.41	$7,413.10
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 $3,548.13 / $4,897.79 / $6,606.93	Professional		$3,548.13	$4,897.79	$6,606.93
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 $2,630.27 / $3,981.07 / $7,079.46	Professional		$2,630.27	$3,981.07	$7,079.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,570.40 / $4,168.69	Professional		$2,187.76	$2,570.40	$4,168.69