Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $7,762.47 / $20,892.96	Facility		$1,513.56	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $912.01 / $2,089.30	Professional		$707.95	$912.01	$2,089.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $14,454.40	Facility		$707.95	$870.96	$14,454.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,288.25 / $2,398.83	Professional		$741.31	$1,288.25	$2,398.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,621.81 / $12,022.64	Facility		$831.76	$1,621.81	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,548.82 / $9,332.54	Professional		$794.33	$1,548.82	$9,332.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $363.08	Professional		$32.36	$33.11	$363.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,513.56 / $1,621.81	Facility		$1,288.25	$1,513.56	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,096.48 / $2,187.76	Facility		$1,071.52	$1,096.48	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,698.24 / $2,290.87	Professional		$1,096.48	$1,698.24	$2,290.87
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 $1,071.52 / $1,513.56 / $2,041.74	Professional		$1,071.52	$1,513.56	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $21,379.62 / $41,686.94	Facility		$3,467.37	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,174.90 / $2,187.76	Professional		$794.33	$1,174.90	$2,187.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $851.14 / $1,412.54	Professional		$741.31	$851.14	$1,412.54