Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $7,943.28 / $24,547.09	Facility		$1,621.81	$7,943.28	$24,547.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,000.00 / $2,290.87	Professional		$776.25	$1,000.00	$2,290.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $6,918.31	Facility		$1,380.38	$1,479.11	$6,918.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,380.38 / $2,570.40	Professional		$794.33	$1,380.38	$2,570.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,778.28 / $11,220.18	Facility		$870.96	$1,778.28	$11,220.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,698.24 / $8,709.64	Professional		$870.96	$1,698.24	$8,709.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,659.59 / $1,698.24	Facility		$1,348.96	$1,659.59	$1,698.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,778.28	Facility		$1,148.15	$1,148.15	$1,778.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $2,454.71	Professional		$1,148.15	$1,778.28	$2,454.71
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 $1,148.15 / $1,621.81 / $2,187.76	Professional		$1,148.15	$1,621.81	$2,187.76
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 $851.14 / $1,288.25 / $2,344.23	Professional		$851.14	$1,288.25	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $891.25 / $1,479.11	Professional		$776.25	$891.25	$1,479.11