Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $7,943.28 / $20,892.96	Facility		$2,454.71	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $3,715.35	Professional		$1,202.26	$1,584.89	$3,715.35
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 $1,288.25 / $2,238.72 / $4,265.80	Professional		$1,288.25	$2,238.72	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,884.03 / $10,000.00	Facility		$1,348.96	$2,884.03	$10,000.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,754.23 / $6,606.93	Professional		$1,348.96	$2,754.23	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,630.27 / $2,818.38	Facility		$1,905.46	$2,630.27	$2,818.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,949.84	Facility		$1,905.46	$1,905.46	$1,949.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,019.95 / $4,073.80	Professional		$1,949.84	$3,019.95	$4,073.80
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 $1,905.46 / $2,691.53 / $3,548.13	Professional		$1,905.46	$2,691.53	$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 $1,348.96 / $2,041.74 / $3,890.45	Professional		$1,348.96	$2,041.74	$3,890.45
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