Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $7,762.47 / $20,892.96	Facility		$1,047.13	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $616.60 / $1,412.54	Professional		$478.63	$616.60	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $4,466.84	Facility		$707.95	$870.96	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $891.25 / $1,659.59	Professional		$512.86	$891.25	$1,659.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,122.02 / $4,265.80	Facility		$575.44	$1,122.02	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,071.52 / $2,818.38	Professional		$512.86	$1,071.52	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $251.19	Professional		$32.36	$33.11	$251.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,023.29 / $1,122.02	Facility		$812.83	$1,023.29	$1,122.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $758.58 / $977.24	Facility		$724.44	$758.58	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,174.90 / $1,584.89	Professional		$758.58	$1,174.90	$1,584.89
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 $741.31 / $1,047.13 / $1,412.54	Professional		$741.31	$1,047.13	$1,412.54
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 $537.03 / $794.33 / $1,445.44	Professional		$537.03	$794.33	$1,445.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $602.56 / $1,000.00	Professional		$524.81	$602.56	$1,000.00