Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $6,025.60 / $18,620.87	Facility		$1,445.44	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $870.96 / $1,995.26	Professional		$707.95	$870.96	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $1,862.09	Facility		$630.96	$758.58	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,202.26 / $2,290.87	Professional		$588.84	$1,202.26	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,570.40	Facility		$812.83	$1,380.38	$2,570.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,230.27 / $1,949.84	Professional		$741.31	$1,230.27	$1,949.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $346.74	Professional		$32.36	$33.11	$346.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,479.11 / $1,513.56	Facility		$1,122.02	$1,479.11	$1,513.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,023.29 / $1,047.13	Facility		$741.31	$1,023.29	$1,047.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $2,187.76	Professional		$1,047.13	$1,621.81	$2,187.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $8,317.64	Facility		$3,311.31	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,479.11 / $1,862.09	Professional		$1,096.48	$1,479.11	$1,862.09
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $4,897.79 / $8,709.64	Facility		$933.25	$4,897.79	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,071.52 / $1,905.46	Professional		$691.83	$1,071.52	$1,905.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $812.83 / $1,348.96	Professional		$707.95	$812.83	$1,348.96