Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $7,762.47 / $20,892.96	Facility		$1,288.25	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $776.25 / $1,737.80	Professional		$602.56	$776.25	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $4,466.84	Facility		$707.95	$870.96	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,096.48 / $2,089.30	Professional		$645.65	$1,096.48	$2,089.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,380.38 / $4,265.80	Facility		$645.65	$1,380.38	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,288.25 / $2,818.38	Professional		$630.96	$1,288.25	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,288.25 / $1,380.38	Facility		$977.24	$1,288.25	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $933.25 / $977.24	Facility		$912.01	$933.25	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,445.44 / $1,949.84	Professional		$933.25	$1,445.44	$1,949.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $9,332.54 / $17,378.01	Facility		$7,079.46	$9,332.54	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,288.25 / $1,737.80	Professional		$933.25	$1,288.25	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $11,220.18 / $18,620.87	Facility		$3,467.37	$11,220.18	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $977.24 / $1,819.70	Professional		$645.65	$977.24	$1,819.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $741.31 / $1,230.27	Professional		$645.65	$741.31	$1,230.27