Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $8,128.31 / $20,892.96	Facility		$2,089.30	$8,128.31	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,258.93 / $2,951.21	Professional		$1,000.00	$1,258.93	$2,951.21
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 $1,096.48 / $1,819.70 / $3,388.44	Professional		$1,096.48	$1,819.70	$3,388.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,089.30 / $4,265.80	Facility		$1,174.90	$2,089.30	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $2,041.74 / $3,090.30	Professional		$1,122.02	$2,041.74	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $457.09	Professional		$32.36	$33.11	$457.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $2,238.72	Facility		$1,698.24	$2,137.96	$2,238.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,548.82	Facility		$1,479.11	$1,479.11	$1,548.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,398.83 / $3,235.94	Professional		$1,548.82	$2,398.83	$3,235.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $8,511.38 / $16,218.10	Facility		$6,456.54	$8,511.38	$16,218.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,089.30 / $2,818.38	Professional		$1,513.56	$2,089.30	$2,818.38
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 $1,122.02 / $1,659.59 / $3,090.30	Professional		$1,122.02	$1,659.59	$3,090.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,174.90 / $1,949.84	Professional		$1,023.29	$1,174.90	$1,949.84