Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $7,943.28 / $22,908.68	Facility		$4,168.69	$7,943.28	$22,908.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,511.89 / $5,495.41	Professional		$1,778.28	$2,511.89	$5,495.41
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 $2,089.30 / $3,630.78 / $6,918.31	Professional		$2,089.30	$3,630.78	$6,918.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $4,570.88 / $36,307.81	Facility		$2,089.30	$4,570.88	$36,307.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $4,365.16 / $23,988.33	Professional		$2,089.30	$4,365.16	$23,988.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $4,168.69 / $4,677.35	Facility		$3,235.94	$4,168.69	$4,677.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,235.94	Facility		$3,090.30	$3,090.30	$3,235.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $5,011.87 / $6,760.83	Professional		$3,235.94	$5,011.87	$6,760.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36,307.81 / $46,773.51 / $91,201.08	Facility		$36,307.81	$46,773.51	$91,201.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,365.16 / $6,025.60	Professional		$3,162.28	$4,365.16	$6,025.60
United Facility/Professional Facility Modifier Low / Median / High Price $6,309.57 / $51,286.14 / $100,000.00	Facility		$6,309.57	$51,286.14	$100,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,311.31 / $6,309.57	Professional		$2,290.87	$3,311.31	$6,309.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,570.40 / $4,168.69	Professional		$2,238.72	$2,570.40	$4,168.69