Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $7,762.47 / $20,892.96	Facility		$2,570.40	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,513.56 / $3,311.31	Professional		$1,202.26	$1,513.56	$3,311.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $3,388.44	Facility		$707.95	$870.96	$3,388.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,187.76 / $4,265.80	Professional		$1,202.26	$2,187.76	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,137.96 / $3,715.35	Facility		$1,258.93	$2,137.96	$3,715.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,089.30 / $3,388.44	Professional		$1,258.93	$2,089.30	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $575.44	Professional		$32.36	$33.11	$575.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $2,884.03	Facility		$1,698.24	$2,570.40	$2,884.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,949.84	Facility		$1,819.70	$1,819.70	$1,949.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,019.95 / $4,073.80	Professional		$1,949.84	$3,019.95	$4,073.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $8,128.31 / $15,488.17	Facility		$5,370.32	$8,128.31	$15,488.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,570.40 / $3,388.44	Professional		$1,862.09	$2,570.40	$3,388.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $8,511.38 / $16,595.87	Facility		$1,122.02	$8,511.38	$16,595.87
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,949.84 / $3,715.35	Professional		$1,288.25	$1,949.84	$3,715.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,479.11 / $2,454.71	Professional		$1,288.25	$1,479.11	$2,454.71