Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $3,548.13 / $18,620.87	Facility		$1,288.25	$3,548.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $1,778.28	Professional		$575.44	$724.44	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $501.19 / $3,715.35	Facility		$467.74	$501.19	$3,715.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,047.13 / $2,137.96	Professional		$616.60	$1,047.13	$2,137.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,318.26 / $3,890.45	Facility		$616.60	$1,318.26	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,258.93 / $2,818.38	Professional		$616.60	$1,258.93	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,230.27 / $1,380.38	Facility		$891.25	$1,230.27	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $977.24	Facility		$933.25	$933.25	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,445.44 / $1,949.84	Professional		$933.25	$1,445.44	$1,949.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $9,120.11 / $17,378.01	Facility		$6,165.95	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,288.25 / $1,778.28	Professional		$954.99	$1,288.25	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $9,549.93 / $18,620.87	Facility		$1,122.02	$9,549.93	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $954.99 / $1,778.28	Professional		$676.08	$954.99	$1,778.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $794.33 / $1,318.26	Professional		$691.83	$794.33	$1,318.26