Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $7,943.28 / $20,892.96	Facility		$1,584.89	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $954.99 / $2,344.23	Professional		$758.58	$954.99	$2,344.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $933.25 / $8,317.64	Facility		$891.25	$933.25	$8,317.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,630.27	Professional		$812.83	$1,380.38	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,698.24 / $8,128.31	Facility		$794.33	$1,698.24	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,621.81 / $6,309.57	Professional		$794.33	$1,621.81	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,548.82 / $1,698.24	Facility		$1,202.26	$1,548.82	$1,698.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $2,187.76	Facility		$1,148.15	$1,148.15	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,819.70 / $2,398.83	Professional		$1,148.15	$1,819.70	$2,398.83
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 $1,174.90 / $1,621.81 / $2,187.76	Professional		$1,174.90	$1,621.81	$2,187.76
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 $812.83 / $1,202.26 / $2,238.72	Professional		$812.83	$1,202.26	$2,238.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $954.99 / $1,548.82	Professional		$831.76	$954.99	$1,548.82