Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $3,630.78 / $18,620.87	Facility		$616.60	$3,630.78	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $1,096.48 / $2,951.21	Professional		$323.59	$1,096.48	$2,951.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Facility		$3,801.89	$3,801.89	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,096.48 / $4,365.16	Professional		$426.58	$1,096.48	$4,365.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $2,290.87 / $12,022.64	Facility		$588.84	$2,290.87	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,905.46 / $3,801.89	Professional		$602.56	$1,905.46	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $208.93	Professional		$32.36	$33.11	$208.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,511.89 / $2,884.03	Facility		$1,778.28	$2,511.89	$2,884.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,089.30	Facility		$1,949.84	$1,949.84	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,096.48 / $3,630.78	Professional		$457.09	$1,096.48	$3,630.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $9,120.11 / $17,378.01	Facility		$6,165.95	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,023.29 / $3,311.31	Professional		$457.09	$1,023.29	$3,311.31
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $11,748.98 / $19,054.61	Facility		$3,311.31	$11,748.98	$19,054.61
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,513.56 / $3,548.13	Professional		$426.58	$1,513.56	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $602.56 / $3,162.28	Professional		$363.08	$602.56	$3,162.28