Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $7,762.47 / $20,892.96	Facility		$1,318.26	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $758.58 / $1,819.70	Professional		$616.60	$758.58	$1,819.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $4,466.84	Facility		$707.95	$870.96	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,122.02 / $2,089.30	Professional		$660.69	$1,122.02	$2,089.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,412.54 / $4,265.80	Facility		$724.44	$1,412.54	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,348.96 / $2,818.38	Professional		$676.08	$1,348.96	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,288.25 / $1,380.38	Facility		$1,096.48	$1,288.25	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $954.99 / $977.24	Facility		$933.25	$954.99	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,479.11 / $1,995.26	Professional		$954.99	$1,479.11	$1,995.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,760.83 / $9,120.11 / $17,378.01	Facility		$6,760.83	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,318.26 / $1,778.28	Professional		$933.25	$1,318.26	$1,778.28
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 $676.08 / $1,000.00 / $1,862.09	Professional		$676.08	$1,000.00	$1,862.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $741.31 / $1,230.27	Professional		$645.65	$741.31	$1,230.27