Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $7,943.28 / $20,892.96	Facility		$2,570.40	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,621.81 / $3,715.35	Professional		$1,122.02	$1,621.81	$3,715.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $6,918.31	Facility		$4,168.69	$4,168.69	$6,918.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,570.40 / $4,168.69	Professional		$1,380.38	$2,570.40	$4,168.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $3,090.30 / $15,848.93	Facility		$1,548.82	$3,090.30	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,884.03 / $5,495.41	Professional		$1,548.82	$2,884.03	$5,495.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,454.71 / $2,691.53	Facility		$1,778.28	$2,454.71	$2,691.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,862.09 / $1,862.09	Facility		$1,819.70	$1,862.09	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $3,090.30 / $3,890.45	Professional		$1,862.09	$3,090.30	$3,890.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $16,595.87 / $31,622.78	Facility		$10,964.78	$16,595.87	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,630.27 / $3,467.37	Professional		$1,862.09	$2,630.27	$3,467.37
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $20,417.38 / $35,481.34	Facility		$3,467.37	$20,417.38	$35,481.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,949.84 / $3,801.89	Professional		$1,288.25	$1,949.84	$3,801.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,778.28 / $2,511.89	Professional		$1,318.26	$1,778.28	$2,511.89