Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $7,762.47 / $20,892.96	Facility		$2,454.71	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,584.89 / $3,715.35	Professional		$1,258.93	$1,584.89	$3,715.35
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 $1,348.96 / $2,290.87 / $4,265.80	Professional		$1,348.96	$2,290.87	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $2,818.38 / $8,128.31	Facility		$1,445.44	$2,818.38	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,691.53 / $6,309.57	Professional		$1,380.38	$2,691.53	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $169.82	Professional		$32.36	$33.11	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,570.40 / $2,818.38	Facility		$1,995.26	$2,570.40	$2,818.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $2,187.76	Facility		$1,905.46	$1,905.46	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,951.21 / $3,981.07	Professional		$1,905.46	$2,951.21	$3,981.07
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 $1,949.84 / $2,691.53 / $3,548.13	Professional		$1,949.84	$2,691.53	$3,548.13
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 $1,348.96 / $2,041.74 / $3,801.89	Professional		$1,348.96	$2,041.74	$3,801.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,513.56 / $2,511.89	Professional		$1,318.26	$1,513.56	$2,511.89