Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,454.71 / $20,892.96	Facility		$1,621.81	$2,454.71	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $954.99 / $2,238.72	Professional		$794.33	$954.99	$2,238.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $707.95 / $8,317.64	Facility		$501.19	$707.95	$8,317.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,348.96 / $2,570.40	Professional		$676.08	$1,348.96	$2,570.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,778.28 / $7,079.46	Facility		$977.24	$1,778.28	$7,079.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,584.89 / $3,715.35	Professional		$812.83	$1,584.89	$3,715.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $1,698.24	Facility		$1,258.93	$1,621.81	$1,698.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $4,168.69	Facility		$1,148.15	$1,148.15	$4,168.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,819.70 / $2,454.71	Professional		$1,148.15	$1,819.70	$2,454.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $16,595.87 / $31,622.78	Facility		$10,964.78	$16,595.87	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,621.81 / $2,137.96	Professional		$1,288.25	$1,621.81	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $17,378.01 / $33,113.11	Facility		$2,884.03	$17,378.01	$33,113.11
United Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,202.26 / $2,137.96	Professional		$794.33	$1,202.26	$2,137.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $912.01 / $1,513.56	Professional		$794.33	$912.01	$1,513.56