Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,089.30 / $20,892.96	Facility		$1,412.54	$2,089.30	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $851.14 / $1,995.26	Professional		$660.69	$851.14	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $870.96	Facility		$758.58	$758.58	$870.96
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 / $17,782.79	Facility		$776.25	$1,513.56	$17,782.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,445.44 / $11,748.98	Professional		$724.44	$1,445.44	$11,748.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,412.54 / $1,513.56	Facility		$1,047.13	$1,412.54	$1,513.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,023.29	Facility		$1,000.00	$1,000.00	$1,023.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $2,238.72	Professional		$1,023.29	$1,584.89	$2,238.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $28,183.83 / $36,307.81 / $70,794.58	Facility		$28,183.83	$36,307.81	$70,794.58
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 $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 $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 $724.44 / $831.76 / $1,380.38	Professional		$724.44	$831.76	$1,380.38