Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $8,912.51 / $28,183.83	Facility		$1,230.27	$8,912.51	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $724.44 / $1,621.81	Professional		$602.56	$724.44	$1,621.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $870.96 / $16,595.87	Facility		$501.19	$870.96	$16,595.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,047.13 / $1,949.84	Professional		$645.65	$1,047.13	$1,949.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,380.38 / $17,378.01	Facility		$776.25	$1,380.38	$17,378.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,202.26 / $9,120.11	Professional		$616.60	$1,202.26	$9,120.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,258.93 / $1,318.26	Facility		$1,071.52	$1,258.93	$1,318.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $10,232.93	Facility		$891.25	$891.25	$10,232.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,380.38 / $1,905.46	Professional		$891.25	$1,380.38	$1,905.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $20,417.38 / $28,840.32 / $56,234.13	Facility		$20,417.38	$28,840.32	$56,234.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,258.93 / $1,659.59	Professional		$1,000.00	$1,258.93	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $30,199.52 / $58,884.37	Facility		$3,235.94	$30,199.52	$58,884.37
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $954.99 / $1,659.59	Professional		$630.96	$954.99	$1,659.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $707.95 / $1,174.90	Professional		$616.60	$707.95	$1,174.90