Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $7,943.28 / $20,892.96	Facility		$1,380.38	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $812.83 / $1,949.84	Professional		$630.96	$812.83	$1,949.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,071.52 / $4,466.84	Facility		$1,000.00	$1,071.52	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,148.15 / $2,238.72	Professional		$676.08	$1,148.15	$2,238.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,412.54 / $4,265.80	Facility		$660.69	$1,412.54	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,348.96 / $2,818.38	Professional		$660.69	$1,348.96	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,318.26 / $1,445.44	Facility		$1,000.00	$1,318.26	$1,445.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Facility		$977.24	$977.24	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,548.82 / $2,041.74	Professional		$977.24	$1,548.82	$2,041.74
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 $1,000.00 / $1,380.38 / $1,862.09	Professional		$1,000.00	$1,380.38	$1,862.09
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 $691.83 / $1,023.29 / $1,905.46	Professional		$691.83	$1,023.29	$1,905.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $812.83 / $1,348.96	Professional		$707.95	$812.83	$1,348.96