Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $7,762.47 / $20,892.96	Facility		$1,698.24	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $2,344.23	Professional		$758.58	$977.24	$2,344.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $10,000.00	Facility		$707.95	$870.96	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,412.54 / $2,754.23	Professional		$831.76	$1,412.54	$2,754.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,737.80 / $9,772.37	Facility		$891.25	$1,737.80	$9,772.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,659.59 / $8,128.31	Professional		$831.76	$1,659.59	$8,128.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $398.11	Professional		$32.36	$33.11	$398.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,621.81 / $1,778.28	Facility		$1,202.26	$1,621.81	$1,778.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,230.27 / $2,818.38	Facility		$1,202.26	$1,230.27	$2,818.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,905.46 / $2,511.89	Professional		$1,230.27	$1,905.46	$2,511.89
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 $1,230.27 / $1,698.24 / $2,290.87	Professional		$1,230.27	$1,698.24	$2,290.87
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 $851.14 / $1,258.93 / $2,344.23	Professional		$851.14	$1,258.93	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,000.00 / $1,659.59	Professional		$870.96	$1,000.00	$1,659.59