Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $7,762.47 / $20,892.96	Facility		$1,047.13	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $616.60 / $1,479.11	Professional		$478.63	$616.60	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $1,071.52	Facility		$707.95	$870.96	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $891.25 / $1,659.59	Professional		$489.78	$891.25	$1,659.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $724.44 / $1,445.44	Facility		$489.78	$724.44	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $724.44 / $1,348.96	Professional		$489.78	$724.44	$1,348.96
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 $776.25 / $1,047.13 / $1,096.48	Facility		$776.25	$1,047.13	$1,096.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $724.44 / $758.58	Facility		$707.95	$724.44	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,174.90 / $1,584.89	Professional		$758.58	$1,174.90	$1,584.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,995.26 / $3,801.89	Facility		$1,348.96	$1,995.26	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,023.29 / $1,412.54	Professional		$741.31	$1,023.29	$1,412.54
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,454.71 / $4,786.30	Facility		$891.25	$2,454.71	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $794.33 / $1,479.11	Professional		$512.86	$794.33	$1,479.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $602.56 / $977.24	Professional		$524.81	$602.56	$977.24