Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $7,943.28 / $20,892.96	Facility		$1,513.56	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $933.25 / $2,137.96	Professional		$724.44	$933.25	$2,137.96
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 $776.25 / $1,318.26 / $2,398.83	Professional		$776.25	$1,318.26	$2,398.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,621.81 / $12,589.25	Facility		$891.25	$1,621.81	$12,589.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,584.89 / $8,317.64	Professional		$794.33	$1,584.89	$8,317.64
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 $1,202.26 / $1,513.56 / $1,621.81	Facility		$1,202.26	$1,513.56	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,096.48	Facility		$1,071.52	$1,071.52	$1,096.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,698.24 / $2,290.87	Professional		$1,096.48	$1,698.24	$2,290.87
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 $1,096.48 / $1,513.56 / $2,041.74	Professional		$1,096.48	$1,513.56	$2,041.74
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 $794.33 / $1,148.15 / $2,089.30	Professional		$794.33	$1,148.15	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $831.76 / $1,380.38	Professional		$724.44	$831.76	$1,380.38