Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $7,943.28 / $20,892.96	Facility		$2,818.38	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,398.83 / $5,370.32	Professional		$1,905.46	$2,398.83	$5,370.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $870.96	Facility		$758.58	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,311.31 / $6,309.57	Professional		$2,041.74	$3,311.31	$6,309.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $4,168.69 / $12,022.64	Facility		$2,290.87	$4,168.69	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $4,073.80 / $8,128.31	Professional		$2,290.87	$4,073.80	$8,128.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,073.80 / $4,168.69	Facility		$3,019.95	$4,073.80	$4,168.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility		$2,818.38	$2,818.38	$2,818.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $4,466.84 / $6,025.60	Professional		$2,818.38	$4,466.84	$6,025.60
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 $2,818.38 / $3,981.07 / $5,248.07	Professional		$2,818.38	$3,981.07	$5,248.07
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $21,379.62 / $41,686.94	Facility		$4,265.80	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,162.28 / $5,754.40	Professional		$2,137.96	$3,162.28	$5,754.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,137.96 / $3,548.13	Professional		$1,862.09	$2,137.96	$3,548.13