Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $6,025.60 / $18,620.87	Facility		$1,230.27	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $741.31 / $1,698.24	Professional		$575.44	$741.31	$1,698.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $676.08 / $8,317.64	Facility		$630.96	$676.08	$8,317.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,047.13 / $1,949.84	Professional		$630.96	$1,047.13	$1,949.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,288.25 / $8,128.31	Facility		$676.08	$1,288.25	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,258.93 / $6,309.57	Professional		$676.08	$1,258.93	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $79.43	Professional		$32.36	$33.11	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,202.26 / $1,288.25	Facility		$977.24	$1,202.26	$1,288.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $891.25 / $2,187.76	Facility		$851.14	$891.25	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,380.38 / $1,862.09	Professional		$891.25	$1,380.38	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $20,417.38 / $38,904.51	Facility		$13,803.84	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,230.27 / $1,659.59	Professional		$870.96	$1,230.27	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $21,379.62 / $41,686.94	Facility		$2,454.71	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $954.99 / $1,737.80	Professional		$630.96	$954.99	$1,737.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $707.95 / $1,174.90	Professional		$616.60	$707.95	$1,174.90