Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $3,388.44 / $18,620.87	Facility		$691.83	$3,388.44	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $524.81 / $1,174.90	Professional		$338.84	$524.81	$1,174.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $10,000.00	Facility		$707.95	$870.96	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $691.83 / $1,445.44	Professional		$398.11	$691.83	$1,445.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $758.58 / $6,456.54	Facility		$416.87	$758.58	$6,456.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $741.31 / $3,715.35	Professional		$416.87	$741.31	$3,715.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,000.00 / $1,023.29	Facility		$724.44	$1,000.00	$1,023.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $691.83 / $3,019.95	Facility		$676.08	$691.83	$3,019.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $851.14 / $1,258.93	Professional		$501.19	$851.14	$1,258.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $20,417.38 / $38,904.51	Facility		$13,803.84	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $758.58 / $1,202.26	Professional		$467.74	$758.58	$1,202.26
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 $426.58 / $660.69 / $1,258.93	Professional		$426.58	$660.69	$1,258.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $512.86 / $724.44	Professional		$331.13	$512.86	$724.44