Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $12,302.69 / $26,915.35	Facility		$1,288.25	$12,302.69	$26,915.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $2,570.40	Professional		$616.60	$851.14	$2,570.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,096.48 / $2,089.30	Professional		$660.69	$1,096.48	$2,089.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,380.38 / $8,709.64	Facility		$676.08	$1,380.38	$8,709.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,318.26 / $6,309.57	Professional		$676.08	$1,318.26	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $281.84	Professional		$32.36	$33.11	$281.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,288.25 / $1,380.38	Facility		$1,023.29	$1,288.25	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $933.25	Facility		$912.01	$912.01	$933.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,445.44 / $1,949.84	Professional		$933.25	$1,445.44	$1,949.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,488.17 / $20,892.96 / $38,904.51	Facility		$15,488.17	$20,892.96	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,288.25 / $1,737.80	Professional		$933.25	$1,288.25	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $21,379.62 / $41,686.94	Facility		$2,454.71	$21,379.62	$41,686.94
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 $630.96 / $724.44 / $1,202.26	Professional		$630.96	$724.44	$1,202.26