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 $1,819.70 / $2,398.83 / $5,495.41	Professional		$1,819.70	$2,398.83	$5,495.41
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 $1,995.26 / $3,388.44 / $6,309.57	Professional		$1,995.26	$3,388.44	$6,309.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,265.80 / $10,000.00	Facility		$2,238.72	$4,265.80	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $4,073.80 / $6,918.31	Professional		$2,089.30	$4,073.80	$6,918.31
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 $3,090.30 / $3,890.45 / $4,265.80	Facility		$3,090.30	$3,890.45	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $2,884.03	Facility		$2,818.38	$2,818.38	$2,884.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,466.84 / $6,025.60	Professional		$2,884.03	$4,466.84	$6,025.60
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 $2,884.03 / $3,981.07 / $5,370.32	Professional		$2,884.03	$3,981.07	$5,370.32
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 $1,995.26 / $3,090.30 / $5,888.44	Professional		$1,995.26	$3,090.30	$5,888.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,137.96 / $3,548.13	Professional		$1,862.09	$2,137.96	$3,548.13