Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $7,943.28 / $20,892.96	Facility		$1,659.59	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $2,290.87	Professional		$794.33	$1,000.00	$2,290.87
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 $870.96 / $1,412.54 / $2,630.27	Professional		$870.96	$1,412.54	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,778.28 / $9,549.93	Facility		$933.25	$1,778.28	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,737.80 / $6,309.57	Professional		$912.01	$1,737.80	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $354.81	Professional		$32.36	$33.11	$354.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,659.59 / $1,778.28	Facility		$1,288.25	$1,659.59	$1,778.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,202.26	Facility		$1,174.90	$1,174.90	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,862.09 / $2,511.89	Professional		$1,202.26	$1,862.09	$2,511.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,125.38 / $18,620.87 / $35,481.34	Facility		$14,125.38	$18,620.87	$35,481.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $2,238.72	Professional		$1,202.26	$1,659.59	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $21,379.62 / $41,686.94	Facility		$3,467.37	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,348.96 / $2,398.83	Professional		$891.25	$1,348.96	$2,398.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $912.01 / $1,513.56	Professional		$794.33	$912.01	$1,513.56