Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $7,943.28 / $24,547.09	Facility		$2,454.71	$7,943.28	$24,547.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,479.11 / $3,388.44	Professional		$1,148.15	$1,479.11	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,698.24 / $19,054.61	Facility		$1,380.38	$1,698.24	$19,054.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,089.30 / $3,890.45	Professional		$1,258.93	$2,089.30	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,630.27 / $16,218.10	Facility		$1,258.93	$2,630.27	$16,218.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,570.40 / $11,748.98	Professional		$1,258.93	$2,570.40	$11,748.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $549.54	Professional		$32.36	$33.11	$549.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,454.71 / $2,570.40	Facility		$1,862.09	$2,454.71	$2,570.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,778.28 / $4,365.16	Facility		$1,737.80	$1,778.28	$4,365.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,754.23 / $3,715.35	Professional		$1,778.28	$2,754.23	$3,715.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26,915.35 / $37,153.52 / $70,794.58	Facility		$26,915.35	$37,153.52	$70,794.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,454.71 / $3,311.31	Professional		$1,737.80	$2,454.71	$3,311.31
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $38,018.94 / $72,443.60	Facility		$4,265.80	$38,018.94	$72,443.60
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,905.46 / $3,548.13	Professional		$1,288.25	$1,905.46	$3,548.13
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