Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,548.13 / $20,892.96	Facility		$2,454.71	$3,548.13	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,548.82 / $3,630.78	Professional		$1,230.27	$1,548.82	$3,630.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $8,317.64	Facility		$707.95	$870.96	$8,317.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,187.76 / $4,168.69	Professional		$1,258.93	$2,187.76	$4,168.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,818.38 / $7,762.47	Facility		$1,348.96	$2,818.38	$7,762.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,754.23 / $5,248.07	Professional		$1,348.96	$2,754.23	$5,248.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $169.82	Professional		$32.36	$33.11	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,511.89 / $2,754.23	Facility		$1,905.46	$2,511.89	$2,754.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility		$1,862.09	$1,862.09	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,884.03 / $3,890.45	Professional		$1,862.09	$2,884.03	$3,890.45
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 $1,862.09 / $2,630.27 / $3,467.37	Professional		$1,862.09	$2,630.27	$3,467.37
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 $1,380.38 / $1,995.26 / $3,801.89	Professional		$1,380.38	$1,995.26	$3,801.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,445.44 / $2,398.83	Professional		$1,258.93	$1,445.44	$2,398.83