Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $7,943.28 / $20,892.96	Facility		$2,630.27	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,659.59 / $3,715.35	Professional		$1,258.93	$1,659.59	$3,715.35
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 $1,348.96 / $2,290.87 / $4,265.80	Professional		$1,348.96	$2,290.87	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,818.38 / $7,762.47	Facility		$1,621.81	$2,818.38	$7,762.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,754.23 / $5,248.07	Professional		$1,513.56	$2,754.23	$5,248.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,691.53 / $2,818.38	Facility		$2,137.96	$2,691.53	$2,818.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,905.46	Facility		$1,862.09	$1,862.09	$1,905.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,951.21 / $3,981.07	Professional		$1,905.46	$2,951.21	$3,981.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $15,135.61 / $28,840.32	Facility		$10,964.78	$15,135.61	$28,840.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,630.27 / $3,548.13	Professional		$1,905.46	$2,630.27	$3,548.13
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 $1,479.11 / $2,137.96 / $3,801.89	Professional		$1,479.11	$2,137.96	$3,801.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,412.54 / $2,344.23	Professional		$1,230.27	$1,412.54	$2,344.23