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 $1,412.54 / $1,819.70 / $4,168.69	Professional		$1,412.54	$1,819.70	$4,168.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,570.40 / $4,786.30	Professional		$1,479.11	$2,570.40	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $3,235.94 / $7,762.47	Facility		$1,621.81	$3,235.94	$7,762.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $3,162.28 / $5,370.32	Professional		$1,621.81	$3,162.28	$5,370.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $645.65	Professional		$32.36	$33.11	$645.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,019.95 / $3,162.28	Facility		$2,344.23	$3,019.95	$3,162.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,137.96	Facility		$2,089.30	$2,089.30	$2,137.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,311.31 / $4,570.88	Professional		$2,137.96	$3,311.31	$4,570.88
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 $2,137.96 / $2,951.21 / $3,981.07	Professional		$2,137.96	$2,951.21	$3,981.07
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 / $2,398.83 / $4,365.16	Professional		$1,621.81	$2,398.83	$4,365.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,659.59 / $2,691.53	Professional		$1,445.44	$1,659.59	$2,691.53