Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $7,943.28 / $20,892.96	Facility		$2,818.38	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,137.96 / $4,365.16	Professional		$1,584.89	$2,137.96	$4,365.16
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 $1,584.89 / $2,754.23 / $5,370.32	Professional		$1,584.89	$2,754.23	$5,370.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,818.38 / $4,897.79	Facility		$1,659.59	$2,818.38	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,691.53 / $4,365.16	Professional		$1,659.59	$2,691.53	$4,365.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $912.01	Professional		$32.36	$33.11	$912.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,467.37 / $3,548.13	Facility		$2,137.96	$3,467.37	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,398.83	Facility		$2,344.23	$2,344.23	$2,398.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,715.35 / $5,128.61	Professional		$2,398.83	$3,715.35	$5,128.61
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 $2,398.83 / $3,311.31 / $4,466.84	Professional		$2,398.83	$3,311.31	$4,466.84
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 $1,584.89 / $2,570.40 / $4,786.30	Professional		$1,584.89	$2,570.40	$4,786.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,819.70 / $3,019.95	Professional		$1,584.89	$1,819.70	$3,019.95