Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $7,762.47 / $20,892.96	Facility		$1,122.02	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $660.69 / $1,548.82	Professional		$524.81	$660.69	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $2,398.83	Facility		$707.95	$870.96	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $954.99 / $1,778.28	Professional		$562.34	$954.99	$1,778.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,122.02 / $2,290.87	Facility		$616.60	$1,122.02	$2,290.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,071.52 / $1,621.81	Professional		$562.34	$1,071.52	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $269.15	Professional		$32.36	$33.11	$269.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,122.02 / $1,174.90	Facility		$831.76	$1,122.02	$1,174.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $812.83	Facility		$776.25	$776.25	$812.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,258.93 / $1,698.24	Professional		$812.83	$1,258.93	$1,698.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $4,570.88 / $8,709.64	Facility		$3,467.37	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,096.48 / $1,513.56	Professional		$794.33	$1,096.48	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $5,623.41 / $10,964.78	Facility		$1,995.26	$5,623.41	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $851.14 / $1,584.89	Professional		$588.84	$851.14	$1,584.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $1,071.52	Professional		$562.34	$645.65	$1,071.52