Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,162.28 / $20,892.96	Facility		$1,862.09	$3,162.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,318.26 / $3,019.95	Professional		$891.25	$1,318.26	$3,019.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,905.46 / $3,715.35	Professional		$1,023.29	$1,905.46	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $2,398.83 / $9,549.93	Facility		$1,096.48	$2,398.83	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $2,290.87 / $6,309.57	Professional		$1,096.48	$2,290.87	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $501.19	Professional		$32.36	$33.11	$501.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,089.30 / $2,454.71	Facility		$1,584.89	$2,089.30	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,698.24	Facility		$1,659.59	$1,659.59	$1,698.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,630.27 / $3,548.13	Professional		$1,698.24	$2,630.27	$3,548.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,791.08 / $20,417.38 / $38,904.51	Facility		$14,791.08	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,344.23 / $3,162.28	Professional		$1,698.24	$2,344.23	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $21,379.62 / $41,686.94	Facility		$4,265.80	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,698.24 / $3,235.94	Professional		$1,148.15	$1,698.24	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,318.26 / $2,187.76	Professional		$1,148.15	$1,318.26	$2,187.76