Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $6,025.60 / $18,620.87	Facility		$2,238.72	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,288.25 / $2,951.21	Professional		$1,047.13	$1,288.25	$2,951.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $4,466.84	Facility		$630.96	$758.58	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,862.09 / $3,630.78	Professional		$1,122.02	$1,862.09	$3,630.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,238.72 / $4,265.80	Facility		$1,174.90	$2,238.72	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $2,041.74 / $3,162.28	Professional		$1,148.15	$2,041.74	$3,162.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $147.91	Professional		$32.36	$33.11	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,290.87 / $2,454.71	Facility		$1,659.59	$2,290.87	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,698.24	Facility		$1,621.81	$1,621.81	$1,698.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $3,548.13	Professional		$1,698.24	$2,570.40	$3,548.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,760.83 / $9,120.11 / $17,378.01	Facility		$6,760.83	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,238.72 / $3,019.95	Professional		$1,659.59	$2,238.72	$3,019.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $11,220.18 / $18,620.87	Facility		$2,454.71	$11,220.18	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,737.80 / $3,235.94	Professional		$1,230.27	$1,737.80	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,380.38 / $2,290.87	Professional		$1,202.26	$1,380.38	$2,290.87