Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $8,128.31 / $20,892.96	Facility		$4,168.69	$8,128.31	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,630.78 / $7,762.47	Professional		$2,754.23	$3,630.78	$7,762.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $5,128.61 / $10,000.00	Professional		$2,951.21	$5,128.61	$10,000.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,888.44 / $12,022.64	Facility		$2,951.21	$5,888.44	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $5,623.41 / $8,912.51	Professional		$2,951.21	$5,623.41	$8,912.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,318.26	Professional		$32.36	$33.11	$1,318.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $5,888.44 / $6,606.93	Facility		$4,570.88	$5,888.44	$6,606.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $4,466.84	Facility		$4,466.84	$4,466.84	$4,466.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $6,918.31 / $9,332.54	Professional		$4,466.84	$6,918.31	$9,332.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,125.38 / $18,620.87 / $35,481.34	Facility		$14,125.38	$18,620.87	$35,481.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $6,165.95 / $8,317.64	Professional		$4,466.84	$6,165.95	$8,317.64
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $21,379.62 / $41,686.94	Facility		$3,467.37	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,677.35 / $8,912.51	Professional		$3,019.95	$4,677.35	$8,912.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,388.44 / $5,623.41	Professional		$2,951.21	$3,388.44	$5,623.41