Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $7,943.28 / $20,892.96	Facility		$2,290.87	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,380.38 / $3,235.94	Professional		$1,096.48	$1,380.38	$3,235.94
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 $1,202.26 / $1,995.26 / $3,715.35	Professional		$1,202.26	$1,995.26	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,454.71 / $12,589.25	Facility		$1,230.27	$2,454.71	$12,589.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,398.83 / $8,317.64	Professional		$1,230.27	$2,398.83	$8,317.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $501.19	Professional		$32.36	$33.11	$501.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,344.23 / $2,454.71	Facility		$1,778.28	$2,344.23	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,698.24	Facility		$1,621.81	$1,621.81	$1,698.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,630.27 / $3,548.13	Professional		$1,698.24	$2,630.27	$3,548.13
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 $1,659.59 / $2,290.87 / $3,090.30	Professional		$1,659.59	$2,290.87	$3,090.30
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 $1,230.27 / $1,819.70 / $3,311.31	Professional		$1,230.27	$1,819.70	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,288.25 / $2,137.96	Professional		$1,122.02	$1,288.25	$2,137.96