Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $7,943.28 / $20,892.96	Facility		$1,513.56	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $933.25 / $2,137.96	Professional		$707.95	$933.25	$2,137.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $933.25 / $1,071.52	Facility		$891.25	$933.25	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,318.26 / $2,454.71	Professional		$776.25	$1,318.26	$2,454.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,659.59 / $13,489.63	Facility		$831.76	$1,659.59	$13,489.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,584.89 / $9,120.11	Professional		$776.25	$1,584.89	$9,120.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $363.08	Professional		$32.36	$33.11	$363.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,513.56 / $1,621.81	Facility		$1,258.93	$1,513.56	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,096.48 / $2,818.38	Facility		$1,071.52	$1,096.48	$2,818.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,698.24 / $2,344.23	Professional		$1,096.48	$1,698.24	$2,344.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,791.08 / $20,417.38 / $38,904.51	Facility		$14,791.08	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,548.82 / $2,041.74	Professional		$1,096.48	$1,548.82	$2,041.74
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 $794.33 / $1,174.90 / $2,187.76	Professional		$794.33	$1,174.90	$2,187.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $870.96 / $1,412.54	Professional		$758.58	$870.96	$1,412.54