Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $7,762.47 / $20,892.96	Facility		$1,621.81	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $977.24 / $2,290.87	Professional		$776.25	$977.24	$2,290.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $10,000.00	Facility		$707.95	$870.96	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,412.54 / $2,630.27	Professional		$851.14	$1,412.54	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,778.28 / $9,549.93	Facility		$912.01	$1,778.28	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,698.24 / $6,309.57	Professional		$851.14	$1,698.24	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $389.05	Professional		$32.36	$33.11	$389.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,659.59 / $1,737.80	Facility		$1,318.26	$1,659.59	$1,737.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,202.26 / $3,162.28	Facility		$1,148.15	$1,202.26	$3,162.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,862.09 / $2,511.89	Professional		$1,202.26	$1,862.09	$2,511.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,791.08 / $20,417.38 / $38,904.51	Facility		$14,791.08	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $2,238.72	Professional		$1,174.90	$1,659.59	$2,238.72
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 $870.96 / $1,258.93 / $2,344.23	Professional		$870.96	$1,258.93	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $933.25 / $1,513.56	Professional		$794.33	$933.25	$1,513.56