Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $7,079.46 / $20,892.96	Facility		$3,890.45	$7,079.46	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,467.37 / $8,317.64	Professional		$2,754.23	$3,467.37	$8,317.64
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 $2,454.71 / $4,786.30 / $9,120.11	Professional		$2,454.71	$4,786.30	$9,120.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,495.41 / $7,762.47	Facility		$3,090.30	$5,495.41	$7,762.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,677.35 / $7,585.78	Professional		$2,754.23	$4,677.35	$7,585.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,348.96	Professional		$32.36	$33.11	$1,348.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $5,754.40 / $6,165.95	Facility		$4,897.79	$5,754.40	$6,165.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,265.80	Facility		$4,168.69	$4,168.69	$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 $4,466.84 / $5,888.44 / $7,413.10	Professional		$4,466.84	$5,888.44	$7,413.10
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 $2,884.03 / $4,265.80 / $7,762.47	Professional		$2,884.03	$4,265.80	$7,762.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $3,235.94 / $5,370.32	Professional		$2,818.38	$3,235.94	$5,370.32