Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $7,943.28 / $20,892.96	Facility		$2,398.83	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,548.82 / $3,548.13	Professional		$1,174.90	$1,548.82	$3,548.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $3,311.31	Facility		$1,995.26	$1,995.26	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,398.83 / $3,801.89	Professional		$1,513.56	$2,398.83	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,818.38 / $8,317.64	Facility		$1,621.81	$2,818.38	$8,317.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,691.53 / $3,548.13	Professional		$1,621.81	$2,691.53	$3,548.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,454.71 / $2,511.89	Facility		$1,862.09	$2,454.71	$2,511.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,737.80	Facility		$1,698.24	$1,698.24	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,884.03 / $3,630.78	Professional		$1,737.80	$2,884.03	$3,630.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,120.11 / $17,378.01	Facility		$5,888.44	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,454.71 / $3,235.94	Professional		$1,737.80	$2,454.71	$3,235.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,481.54 / $19,952.62	Facility		$1,995.26	$11,481.54	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,995.26 / $3,548.13	Professional		$1,258.93	$1,995.26	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $2,187.76	Professional		$1,148.15	$1,548.82	$2,187.76