Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,715.35 / $20,892.96	Facility		$2,691.53	$3,715.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,659.59 / $3,715.35	Professional		$1,380.38	$1,659.59	$3,715.35
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 $1,380.38 / $2,344.23 / $4,265.80	Professional		$1,380.38	$2,344.23	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,691.53 / $3,715.35	Facility		$1,513.56	$2,691.53	$3,715.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,290.87 / $3,630.78	Professional		$1,348.96	$2,290.87	$3,630.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $630.96	Professional		$32.36	$33.11	$630.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,754.23 / $2,951.21	Facility		$2,398.83	$2,754.23	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,090.30 / $4,265.80	Professional		$1,995.26	$3,090.30	$4,265.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,818.38 / $3,715.35	Professional		$2,238.72	$2,818.38	$3,715.35
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 $1,412.54 / $2,089.30 / $3,715.35	Professional		$1,412.54	$2,089.30	$3,715.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,584.89 / $2,630.27	Professional		$1,380.38	$1,584.89	$2,630.27