Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $7,943.28 / $20,892.96	Facility		$2,089.30	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,621.81 / $3,235.94	Professional		$812.83	$1,621.81	$3,235.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $7,079.46 / $7,079.46	Facility		$7,079.46	$7,079.46	$7,079.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,398.83 / $3,801.89	Professional		$1,548.82	$2,398.83	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $23,988.33	Facility		$1,584.89	$3,090.30	$23,988.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,818.38 / $6,760.83	Professional		$1,584.89	$2,818.38	$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 $1,548.82 / $2,344.23 / $2,630.27	Facility		$1,548.82	$2,344.23	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,778.28	Facility		$1,737.80	$1,737.80	$1,778.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,951.21 / $3,801.89	Professional		$1,778.28	$2,951.21	$3,801.89
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 $1,778.28 / $2,570.40 / $3,467.37	Professional		$1,778.28	$2,570.40	$3,467.37
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 $1,230.27 / $1,819.70 / $3,467.37	Professional		$1,230.27	$1,819.70	$3,467.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $2,344.23	Professional		$1,412.54	$1,659.59	$2,344.23