Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $7,943.28 / $22,908.68	Facility		$3,630.78	$7,943.28	$22,908.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,187.76 / $4,786.30	Professional		$1,737.80	$2,187.76	$4,786.30
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 $1,862.09 / $3,162.28 / $5,888.44	Professional		$1,862.09	$3,162.28	$5,888.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,981.07 / $24,547.09	Facility		$1,862.09	$3,981.07	$24,547.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $3,890.45 / $16,218.10	Professional		$1,862.09	$3,890.45	$16,218.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $125.89	Professional		$32.36	$33.11	$125.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $3,715.35 / $3,981.07	Facility		$2,951.21	$3,715.35	$3,981.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,754.23	Facility		$2,630.27	$2,630.27	$2,754.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,265.80 / $5,754.40	Professional		$2,754.23	$4,265.80	$5,754.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34,673.69 / $46,773.51 / $91,201.08	Facility		$34,673.69	$46,773.51	$91,201.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,801.89 / $5,128.61	Professional		$2,691.53	$3,801.89	$5,128.61
United Facility/Professional Facility Modifier Low / Median / High Price $6,309.57 / $38,018.94 / $72,443.60	Facility		$6,309.57	$38,018.94	$72,443.60
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,884.03 / $5,370.32	Professional		$1,995.26	$2,884.03	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,187.76 / $3,630.78	Professional		$1,905.46	$2,187.76	$3,630.78