Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $6,025.60 / $18,620.87	Facility		$1,000.00	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $1,412.54	Professional		$489.78	$630.96	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $4,466.84	Facility		$630.96	$758.58	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $891.25 / $1,621.81	Professional		$537.03	$891.25	$1,621.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,096.48 / $4,265.80	Facility		$602.56	$1,096.48	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,047.13 / $2,818.38	Professional		$602.56	$1,047.13	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,047.13 / $1,071.52	Facility		$851.14	$1,047.13	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $741.31 / $977.24	Facility		$707.95	$741.31	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,148.15 / $1,548.82	Professional		$741.31	$1,148.15	$1,548.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $9,332.54 / $17,378.01	Facility		$7,079.46	$9,332.54	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,023.29 / $1,348.96	Professional		$724.44	$1,023.29	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $11,481.54 / $20,892.96	Facility		$4,265.80	$11,481.54	$20,892.96
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $851.14 / $1,479.11	Professional		$549.54	$851.14	$1,479.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $575.44 / $954.99	Professional		$501.19	$575.44	$954.99