Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $16,218.10 / $23,988.33	Facility		$2,818.38	$16,218.10	$23,988.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,202.26 / $2,454.71	Professional		$1,071.52	$1,202.26	$2,454.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,949.84 / $3,630.78	Professional		$1,148.15	$1,949.84	$3,630.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $2,344.23 / $5,370.32	Facility		$1,380.38	$2,344.23	$5,370.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,290.87 / $3,801.89	Professional		$1,348.96	$2,290.87	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $117.49 / $1,288.25	Professional		$32.36	$117.49	$1,288.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,071.52 / $1,174.90	Facility		$912.01	$1,071.52	$1,174.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,659.59	Facility		$1,621.81	$1,621.81	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,570.40 / $3,467.37	Professional		$1,659.59	$2,570.40	$3,467.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $9,332.54 / $17,378.01	Facility		$7,079.46	$9,332.54	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,290.87 / $3,090.30	Professional		$1,659.59	$2,290.87	$3,090.30
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $11,220.18 / $18,620.87	Facility		$3,467.37	$11,220.18	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,737.80 / $3,311.31	Professional		$1,148.15	$1,737.80	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,348.96 / $2,238.72	Professional		$1,174.90	$1,348.96	$2,238.72