Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $7,762.47 / $20,892.96	Facility		$1,412.54	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $831.76 / $1,949.84	Professional		$630.96	$831.76	$1,949.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $4,466.84	Facility		$707.95	$870.96	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,148.15 / $2,238.72	Professional		$691.83	$1,148.15	$2,238.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,445.44 / $4,265.80	Facility		$660.69	$1,445.44	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,412.54 / $2,818.38	Professional		$660.69	$1,412.54	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $331.13	Professional		$32.36	$33.11	$331.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,380.38 / $1,479.11	Facility		$1,047.13	$1,380.38	$1,479.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,023.29	Facility		$977.24	$977.24	$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 $7,079.46 / $9,332.54 / $17,378.01	Facility		$7,079.46	$9,332.54	$17,378.01
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 $3,467.37 / $11,220.18 / $18,620.87	Facility		$3,467.37	$11,220.18	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,071.52 / $1,995.26	Professional		$691.83	$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