Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $5,754.40 / $22,908.68	Facility		$630.96	$5,754.40	$22,908.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,548.82 / $3,388.44	Professional		$338.84	$1,548.82	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,128.31 / $8,128.31 / $8,128.31	Facility		$8,128.31	$8,128.31	$8,128.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $1,096.48 / $5,495.41	Professional		$446.68	$1,096.48	$5,495.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $3,801.89 / $23,442.29	Facility		$616.60	$3,801.89	$23,442.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $3,235.94 / $5,495.41	Professional		$616.60	$3,235.94	$5,495.41
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 $2,818.38 / $3,388.44 / $4,073.80	Facility		$2,818.38	$3,388.44	$4,073.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,570.40	Facility		$2,454.71	$2,454.71	$2,570.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,122.02 / $4,570.88	Professional		$467.74	$1,122.02	$4,570.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,748.98 / $16,218.10 / $30,902.95	Facility		$11,748.98	$16,218.10	$30,902.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,047.13 / $4,168.69	Professional		$467.74	$1,047.13	$4,168.69
United Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $20,892.96 / $33,884.42	Facility		$4,677.35	$20,892.96	$33,884.42
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,737.80 / $4,570.88	Professional		$467.74	$1,737.80	$4,570.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $575.44 / $3,467.37	Professional		$346.74	$575.44	$3,467.37