Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $7,762.47 / $20,892.96	Facility		$1,659.59	$7,762.47	$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 $707.95 / $870.96 / $4,466.84	Facility		$707.95	$870.96	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,691.53	Professional		$812.83	$1,380.38	$2,691.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,698.24 / $3,890.45	Facility		$812.83	$1,698.24	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,621.81 / $2,884.03	Professional		$812.83	$1,621.81	$2,884.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $371.54	Professional		$32.36	$33.11	$371.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,584.89 / $1,778.28	Facility		$1,230.27	$1,584.89	$1,778.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,862.09 / $2,511.89	Professional		$1,202.26	$1,862.09	$2,511.89
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 $1,202.26 / $1,659.59 / $2,238.72	Professional		$1,202.26	$1,659.59	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $11,220.18 / $18,620.87	Facility		$2,454.71	$11,220.18	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,258.93 / $2,290.87	Professional		$851.14	$1,258.93	$2,290.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,000.00 / $1,621.81	Professional		$851.14	$1,000.00	$1,621.81