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 $1,071.52 / $1,479.11 / $3,311.31	Professional		$1,071.52	$1,479.11	$3,311.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $8,709.64	Facility		$5,248.07	$5,248.07	$8,709.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,290.87 / $3,715.35	Professional		$1,348.96	$2,290.87	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,884.03 / $15,848.93	Facility		$1,584.89	$2,884.03	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,691.53 / $6,918.31	Professional		$1,584.89	$2,691.53	$6,918.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,238.72 / $2,454.71	Facility		$1,698.24	$2,238.72	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $3,548.13	Professional		$1,659.59	$2,754.23	$3,548.13
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 $1,698.24 / $2,344.23 / $3,162.28	Professional		$1,698.24	$2,344.23	$3,162.28
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 $1,122.02 / $1,862.09 / $3,388.44	Professional		$1,122.02	$1,862.09	$3,388.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,479.11 / $2,089.30	Professional		$1,096.48	$1,479.11	$2,089.30