Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,570.40 / $20,892.96	Facility		$1,621.81	$2,570.40	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,096.48 / $2,818.38	Professional		$870.96	$1,096.48	$2,818.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,698.24 / $2,570.40	Professional		$1,071.52	$1,698.24	$2,570.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,137.96 / $23,988.33	Facility		$1,348.96	$2,137.96	$23,988.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,949.84 / $6,760.83	Professional		$1,348.96	$1,949.84	$6,760.83
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 $1,412.54 / $1,659.59 / $1,778.28	Facility		$1,412.54	$1,659.59	$1,778.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,202.26	Facility		$1,174.90	$1,174.90	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,995.26 / $2,570.40	Professional		$1,202.26	$1,995.26	$2,570.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $15,488.17 / $29,512.09	Facility		$10,715.19	$15,488.17	$29,512.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,737.80 / $2,344.23	Professional		$1,202.26	$1,737.80	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $20,417.38 / $33,113.11	Facility		$4,677.35	$20,417.38	$33,113.11
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,380.38 / $2,454.71	Professional		$933.25	$1,380.38	$2,454.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,071.52 / $1,513.56	Professional		$912.01	$1,071.52	$1,513.56