Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $8,128.31 / $21,877.62	Facility		$4,677.35	$8,128.31	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $4,168.69 / $8,128.31	Professional		$3,388.44	$4,168.69	$8,128.31
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 $3,162.28 / $5,888.44 / $10,715.19	Professional		$3,162.28	$5,888.44	$10,715.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $6,760.83 / $9,332.54	Facility		$4,265.80	$6,760.83	$9,332.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $5,888.44 / $9,332.54	Professional		$3,548.13	$5,888.44	$9,332.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $7,079.46 / $7,413.10	Facility		$6,025.60	$7,079.46	$7,413.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $5,011.87 / $5,011.87	Facility		$5,011.87	$5,011.87	$5,011.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,011.87 / $7,762.47 / $10,715.19	Professional		$5,011.87	$7,762.47	$10,715.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $7,079.46 / $9,332.54	Professional		$5,754.40	$7,079.46	$9,332.54
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 $3,630.78 / $5,623.41 / $9,549.93	Professional		$3,630.78	$5,623.41	$9,549.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,890.45 / $6,456.54	Professional		$3,388.44	$3,890.45	$6,456.54