Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $6,025.60 / $18,620.87	Facility		$831.76	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $562.34 / $1,479.11	Professional		$446.68	$562.34	$1,479.11
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 $549.54 / $870.96 / $1,318.26	Professional		$549.54	$870.96	$1,318.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,096.48 / $13,803.84	Facility		$691.83	$1,096.48	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,000.00 / $3,388.44	Professional		$691.83	$1,000.00	$3,388.44
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 $741.31 / $851.14 / $912.01	Facility		$741.31	$851.14	$912.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,023.29 / $1,318.26	Professional		$616.60	$1,023.29	$1,318.26
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 $630.96 / $891.25 / $1,202.26	Professional		$630.96	$891.25	$1,202.26
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 $478.63 / $707.95 / $1,258.93	Professional		$478.63	$707.95	$1,258.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $562.34 / $794.33	Professional		$478.63	$562.34	$794.33