Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $6,025.60 / $18,620.87	Facility		$758.58	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $1,230.27	Professional		$371.54	$524.81	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility		$4,677.35	$4,677.35	$4,677.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $776.25 / $1,258.93	Professional		$501.19	$776.25	$1,258.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,023.29 / $15,488.17	Facility		$616.60	$1,023.29	$15,488.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $954.99 / $6,165.95	Professional		$616.60	$954.99	$6,165.95
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 $537.03 / $758.58 / $831.76	Facility		$537.03	$758.58	$831.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $575.44	Facility		$562.34	$562.34	$575.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $933.25 / $1,230.27	Professional		$575.44	$933.25	$1,230.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $11,220.18 / $21,379.62	Facility		$7,244.36	$11,220.18	$21,379.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $812.83 / $1,096.48	Professional		$562.34	$812.83	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $13,182.57 / $22,387.21	Facility		$3,311.31	$13,182.57	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $575.44 / $1,096.48	Professional		$426.58	$575.44	$1,096.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $549.54 / $776.25	Professional		$467.74	$549.54	$776.25