Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $7,762.47 / $20,892.96	Facility		$1,412.54	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $851.14 / $1,949.84	Professional		$660.69	$851.14	$1,949.84
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 $724.44 / $1,202.26 / $2,290.87	Professional		$724.44	$1,202.26	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,513.56 / $8,128.31	Facility		$776.25	$1,513.56	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,479.11 / $6,309.57	Professional		$741.31	$1,479.11	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $1,513.56	Facility		$1,071.52	$1,412.54	$1,513.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,023.29 / $2,187.76	Facility		$1,000.00	$1,023.29	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $2,137.96	Professional		$1,023.29	$1,584.89	$2,137.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $20,417.38 / $38,904.51	Facility		$13,803.84	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,412.54 / $1,905.46	Professional		$1,023.29	$1,412.54	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $21,379.62 / $41,686.94	Facility		$2,454.71	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,096.48 / $2,041.74	Professional		$741.31	$1,096.48	$2,041.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $794.33 / $1,318.26	Professional		$691.83	$794.33	$1,318.26