Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $7,943.28 / $20,892.96	Facility		$2,187.76	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,412.54 / $3,162.28	Professional		$1,047.13	$1,412.54	$3,162.28
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 $1,288.25 / $2,238.72 / $3,630.78	Professional		$1,288.25	$2,238.72	$3,630.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,818.38 / $15,848.93	Facility		$1,513.56	$2,818.38	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,630.27 / $5,495.41	Professional		$1,479.11	$2,630.27	$5,495.41
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 $1,621.81 / $2,187.76 / $2,398.83	Facility		$1,621.81	$2,187.76	$2,398.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility		$1,621.81	$1,621.81	$1,621.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,691.53 / $3,467.37	Professional		$1,621.81	$2,691.53	$3,467.37
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 $1,621.81 / $2,290.87 / $3,019.95	Professional		$1,621.81	$2,290.87	$3,019.95
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 $1,096.48 / $1,778.28 / $3,311.31	Professional		$1,096.48	$1,778.28	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $2,041.74	Professional		$1,071.52	$1,445.44	$2,041.74