Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,388.44 / $20,892.96	Facility		$2,454.71	$3,388.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,479.11 / $3,388.44	Professional		$1,202.26	$1,479.11	$3,388.44
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 / $2,089.30 / $3,981.07	Professional		$1,096.48	$2,089.30	$3,981.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,398.83 / $3,388.44	Facility		$1,258.93	$2,398.83	$3,388.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,137.96 / $3,311.31	Professional		$1,258.93	$2,137.96	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $588.84	Professional		$32.36	$33.11	$588.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,570.40 / $2,691.53	Facility		$1,905.46	$2,570.40	$2,691.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,818.38 / $3,890.45	Professional		$1,819.70	$2,818.38	$3,890.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,570.40 / $3,388.44	Professional		$1,995.26	$2,570.40	$3,388.44
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 $1,258.93 / $1,862.09 / $3,388.44	Professional		$1,258.93	$1,862.09	$3,388.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,412.54 / $2,344.23	Professional		$1,230.27	$1,412.54	$2,344.23