Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $6,918.31 / $21,877.62	Facility		$4,265.80	$6,918.31	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,548.13 / $6,918.31	Professional		$2,884.03	$3,548.13	$6,918.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $707.95 / $954.99	Facility		$501.19	$707.95	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $5,011.87 / $9,120.11	Professional		$2,691.53	$5,011.87	$9,120.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $5,754.40 / $7,943.28	Facility		$3,548.13	$5,754.40	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,897.79 / $7,943.28	Professional		$3,019.95	$4,897.79	$7,943.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $194.98	Professional		$32.36	$33.11	$194.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,128.61 / $6,025.60 / $6,309.57	Facility		$5,128.61	$6,025.60	$6,309.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Facility		$4,265.80	$4,265.80	$4,265.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $6,606.93 / $9,120.11	Professional		$4,265.80	$6,606.93	$9,120.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $6,025.60 / $7,943.28	Professional		$4,786.30	$6,025.60	$7,943.28
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,258.93 / $5,754.40	Facility		$707.95	$1,258.93	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,677.35 / $8,128.31	Professional		$3,019.95	$4,677.35	$8,128.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,311.31 / $5,495.41	Professional		$2,884.03	$3,311.31	$5,495.41