Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,073.80 / $20,892.96	Facility		$2,818.38	$4,073.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,737.80 / $3,715.35	Professional		$1,445.44	$1,737.80	$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 / $2,454.71 / $4,466.84	Professional		$1,380.38	$2,454.71	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,754.23 / $3,981.07	Facility		$1,737.80	$2,754.23	$3,981.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,511.89 / $3,890.45	Professional		$1,445.44	$2,511.89	$3,890.45
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 $2,511.89 / $2,884.03 / $3,162.28	Facility		$2,511.89	$2,884.03	$3,162.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,089.30	Facility		$2,041.74	$2,041.74	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,235.94 / $4,466.84	Professional		$2,089.30	$3,235.94	$4,466.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,951.21 / $3,801.89	Professional		$2,344.23	$2,951.21	$3,801.89
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 $1,513.56 / $2,398.83 / $3,890.45	Professional		$1,513.56	$2,398.83	$3,890.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,621.81 / $2,691.53	Professional		$1,412.54	$1,621.81	$2,691.53