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 $1,778.28 / $2,344.23 / $4,897.79	Professional		$1,778.28	$2,344.23	$4,897.79
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 / $3,235.94 / $6,309.57	Professional		$1,862.09	$3,235.94	$6,309.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,801.89 / $7,762.47	Facility		$1,995.26	$3,801.89	$7,762.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,715.35 / $5,623.41	Professional		$1,949.84	$3,715.35	$5,623.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,981.07 / $4,265.80	Facility		$2,884.03	$3,981.07	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,951.21	Facility		$2,884.03	$2,884.03	$2,951.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,570.88 / $6,165.95	Professional		$2,951.21	$4,570.88	$6,165.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $16,595.87 / $31,622.78	Facility		$10,964.78	$16,595.87	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,073.80 / $5,495.41	Professional		$2,884.03	$4,073.80	$5,495.41
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 $2,089.30 / $3,019.95 / $5,623.41	Professional		$2,089.30	$3,019.95	$5,623.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,344.23 / $3,890.45	Professional		$2,041.74	$2,344.23	$3,890.45