Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $7,943.28 / $20,892.96	Facility		$2,089.30	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,258.93 / $2,884.03	Professional		$1,000.00	$1,258.93	$2,884.03
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 $1,047.13 / $1,778.28 / $3,311.31	Professional		$1,047.13	$1,778.28	$3,311.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,238.72 / $10,000.00	Facility		$1,258.93	$2,238.72	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $2,137.96 / $6,606.93	Professional		$1,174.90	$2,137.96	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,137.96 / $2,290.87	Facility		$1,778.28	$2,137.96	$2,290.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,513.56	Facility		$1,479.11	$1,479.11	$1,513.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,344.23 / $3,162.28	Professional		$1,513.56	$2,344.23	$3,162.28
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 $1,479.11 / $2,089.30 / $2,818.38	Professional		$1,479.11	$2,089.30	$2,818.38
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 $1,122.02 / $1,659.59 / $2,951.21	Professional		$1,122.02	$1,659.59	$2,951.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,096.48 / $1,819.70	Professional		$954.99	$1,096.48	$1,819.70