Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $7,943.28 / $20,892.96	Facility		$891.25	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $602.56 / $1,412.54	Professional		$467.74	$602.56	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $5,370.32 / $5,370.32	Facility		$5,370.32	$5,370.32	$5,370.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $891.25 / $1,445.44	Professional		$588.84	$891.25	$1,445.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,148.15 / $13,803.84	Facility		$724.44	$1,148.15	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,071.52 / $4,897.79	Professional		$724.44	$1,071.52	$4,897.79
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 $741.31 / $912.01 / $954.99	Facility		$741.31	$912.01	$954.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $660.69	Facility		$645.65	$645.65	$660.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,071.52 / $1,412.54	Professional		$660.69	$1,071.52	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $9,120.11 / $17,378.01	Facility		$6,606.93	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $954.99 / $1,288.25	Professional		$660.69	$954.99	$1,288.25
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 $501.19 / $707.95 / $1,318.26	Professional		$501.19	$707.95	$1,318.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $645.65 / $891.25	Professional		$549.54	$645.65	$891.25