Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,041.74 / $20,892.96	Facility		$1,412.54	$2,041.74	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $870.96 / $1,995.26	Professional		$660.69	$870.96	$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 $691.83 / $1,202.26 / $2,238.72	Professional		$691.83	$1,202.26	$2,238.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,513.56 / $17,782.79	Facility		$707.95	$1,513.56	$17,782.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,412.54 / $11,748.98	Professional		$707.95	$1,412.54	$11,748.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $302.00	Professional		$32.36	$33.11	$302.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $1,479.11	Facility		$1,148.15	$1,380.38	$1,479.11
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 / $2,137.96	Professional		$1,023.29	$1,584.89	$2,137.96
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 $1,000.00 / $1,412.54 / $1,905.46	Professional		$1,000.00	$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 / $1,071.52 / $1,995.26	Professional		$741.31	$1,071.52	$1,995.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $794.33 / $1,318.26	Professional		$691.83	$794.33	$1,318.26