Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $7,762.47 / $20,892.96	Facility		$1,148.15	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $1,621.81	Professional		$537.03	$676.08	$1,621.81
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 $588.84 / $977.24 / $1,819.70	Professional		$588.84	$977.24	$1,819.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,230.27 / $8,128.31	Facility		$630.96	$1,230.27	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,174.90 / $6,309.57	Professional		$602.56	$1,174.90	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $275.42	Professional		$32.36	$33.11	$275.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,122.02 / $1,230.27	Facility		$954.99	$1,122.02	$1,230.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $831.76 / $2,187.76	Facility		$812.83	$831.76	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,288.25 / $1,737.80	Professional		$831.76	$1,288.25	$1,737.80
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 $812.83 / $1,148.15 / $1,548.82	Professional		$812.83	$1,148.15	$1,548.82
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 $602.56 / $891.25 / $1,621.81	Professional		$602.56	$891.25	$1,621.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $660.69 / $1,071.52	Professional		$575.44	$660.69	$1,071.52