Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $7,943.28 / $20,892.96	Facility		$2,137.96	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,288.25 / $2,818.38	Professional		$1,023.29	$1,288.25	$2,818.38
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 $1,023.29 / $1,862.09 / $3,467.37	Professional		$1,023.29	$1,862.09	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,290.87 / $9,549.93	Facility		$1,071.52	$2,290.87	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $2,187.76 / $6,309.57	Professional		$1,071.52	$2,187.76	$6,309.57
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 $1,548.82 / $2,137.96 / $2,344.23	Facility		$1,548.82	$2,137.96	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,584.89	Facility		$1,513.56	$1,513.56	$1,584.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,454.71 / $3,311.31	Professional		$1,584.89	$2,454.71	$3,311.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,125.38 / $18,620.87 / $35,481.34	Facility		$14,125.38	$18,620.87	$35,481.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,187.76 / $2,951.21	Professional		$1,548.82	$2,187.76	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $21,379.62 / $41,686.94	Facility		$4,265.80	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $3,019.95	Professional		$1,174.90	$1,659.59	$3,019.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,318.26 / $2,187.76	Professional		$1,148.15	$1,318.26	$2,187.76