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 $1,230.27 / $1,513.56 / $3,467.37	Professional		$1,230.27	$1,513.56	$3,467.37
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 $1,288.25 / $2,089.30 / $3,890.45	Professional		$1,288.25	$2,089.30	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $2,398.83 / $3,388.44	Facility		$1,380.38	$2,398.83	$3,388.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,089.30 / $3,311.31	Professional		$1,230.27	$2,089.30	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $575.44	Professional		$32.36	$33.11	$575.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,511.89 / $2,691.53	Facility		$1,995.26	$2,511.89	$2,691.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,819.70	Facility		$1,778.28	$1,778.28	$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 / $3,311.31	Professional		$1,995.26	$2,570.40	$3,311.31
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 $1,288.25 / $1,905.46 / $3,388.44	Professional		$1,288.25	$1,905.46	$3,388.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,445.44 / $2,398.83	Professional		$1,258.93	$1,445.44	$2,398.83