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 $1,445.44 / $1,949.84 / $4,466.84	Professional		$1,445.44	$1,949.84	$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 $1,584.89 / $2,754.23 / $5,128.61	Professional		$1,584.89	$2,754.23	$5,128.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,388.44 / $10,000.00	Facility		$1,659.59	$3,388.44	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $3,311.31 / $6,606.93	Professional		$1,659.59	$3,311.31	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,162.28 / $3,388.44	Facility		$2,454.71	$3,162.28	$3,388.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,344.23	Facility		$2,290.87	$2,290.87	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,630.78 / $4,897.79	Professional		$2,344.23	$3,630.78	$4,897.79
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 $2,344.23 / $3,235.94 / $4,265.80	Professional		$2,344.23	$3,235.94	$4,265.80
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 $1,621.81 / $2,511.89 / $4,677.35	Professional		$1,621.81	$2,511.89	$4,677.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,737.80 / $2,818.38	Professional		$1,513.56	$1,737.80	$2,818.38