Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $7,943.28 / $20,892.96	Facility		$2,691.53	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,737.80 / $3,981.07	Professional		$1,348.96	$1,737.80	$3,981.07
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 $1,445.44 / $2,398.83 / $4,570.88	Professional		$1,445.44	$2,398.83	$4,570.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $3,090.30 / $10,000.00	Facility		$1,479.11	$3,090.30	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,951.21 / $6,606.93	Professional		$1,479.11	$2,951.21	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,884.03 / $3,019.95	Facility		$2,238.72	$2,884.03	$3,019.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,089.30	Facility		$2,041.74	$2,041.74	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,235.94 / $4,365.16	Professional		$2,089.30	$3,235.94	$4,365.16
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 $2,089.30 / $2,884.03 / $3,890.45	Professional		$2,089.30	$2,884.03	$3,890.45
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 $1,479.11 / $2,238.72 / $4,168.69	Professional		$1,479.11	$2,238.72	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,548.82 / $2,570.40	Professional		$1,348.96	$1,548.82	$2,570.40