Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,818.38 / $20,892.96	Facility		$2,041.74	$2,818.38	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,258.93 / $2,691.53	Professional		$1,047.13	$1,258.93	$2,691.53
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 $1,096.48 / $1,778.28 / $3,235.94	Professional		$1,096.48	$1,778.28	$3,235.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,995.26 / $2,818.38	Facility		$1,258.93	$1,995.26	$2,818.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,819.70 / $2,754.23	Professional		$1,047.13	$1,819.70	$2,754.23
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 $1,819.70 / $2,089.30 / $2,238.72	Facility		$1,819.70	$2,089.30	$2,238.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility		$1,513.56	$1,513.56	$1,513.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,344.23 / $3,235.94	Professional		$1,513.56	$2,344.23	$3,235.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $2,754.23	Professional		$1,698.24	$2,137.96	$2,754.23
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 $1,096.48 / $1,737.80 / $2,884.03	Professional		$1,096.48	$1,737.80	$2,884.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,202.26 / $1,995.26	Professional		$1,047.13	$1,202.26	$1,995.26