Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,513.56 / $13,803.84	Facility		$691.83	$1,513.56	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $1,479.11	Professional		$323.59	$537.03	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $4,466.84	Facility		$630.96	$758.58	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $724.44 / $1,513.56	Professional		$389.05	$724.44	$1,513.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $758.58 / $2,884.03	Facility		$426.58	$758.58	$2,884.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $758.58 / $1,819.70	Professional		$426.58	$758.58	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $194.98	Professional		$32.36	$33.11	$194.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,023.29 / $1,071.52	Facility		$724.44	$1,023.29	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $724.44 / $977.24	Facility		$707.95	$724.44	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $891.25 / $1,318.26	Professional		$512.86	$891.25	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $9,120.11 / $17,378.01	Facility		$6,165.95	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $776.25 / $1,258.93	Professional		$489.78	$776.25	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $10,471.29 / $18,620.87	Facility		$1,995.26	$10,471.29	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $676.08 / $1,318.26	Professional		$436.52	$676.08	$1,318.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $562.34 / $794.33	Professional		$354.81	$562.34	$794.33