Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,398.83 / $20,892.96	Facility		$1,737.80	$2,398.83	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,071.52 / $2,344.23	Professional		$758.58	$1,071.52	$2,344.23
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 $831.76 / $1,445.44 / $2,818.38	Professional		$831.76	$1,445.44	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,862.09 / $24,547.09	Facility		$851.14	$1,862.09	$24,547.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,778.28 / $16,218.10	Professional		$851.14	$1,778.28	$16,218.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,584.89 / $1,905.46	Facility		$1,258.93	$1,584.89	$1,905.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,288.25	Facility		$1,258.93	$1,258.93	$1,288.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,995.26 / $2,691.53	Professional		$1,288.25	$1,995.26	$2,691.53
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 $1,288.25 / $1,778.28 / $2,398.83	Professional		$1,288.25	$1,778.28	$2,398.83
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 $851.14 / $1,348.96 / $2,511.89	Professional		$851.14	$1,348.96	$2,511.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $977.24 / $1,621.81	Professional		$851.14	$977.24	$1,621.81