Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,548.13 / $20,892.96	Facility		$2,570.40	$3,548.13	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,584.89 / $3,548.13	Professional		$1,288.25	$1,584.89	$3,548.13
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 $1,318.26 / $2,187.76 / $4,073.80	Professional		$1,318.26	$2,187.76	$4,073.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $2,570.40 / $3,630.78	Facility		$1,445.44	$2,570.40	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,238.72 / $3,548.13	Professional		$1,288.25	$2,238.72	$3,548.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $602.56	Professional		$32.36	$33.11	$602.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,630.27 / $2,754.23	Facility		$2,137.96	$2,630.27	$2,754.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,905.46	Facility		$1,862.09	$1,862.09	$1,905.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,951.21 / $4,073.80	Professional		$1,905.46	$2,951.21	$4,073.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,691.53 / $3,467.37	Professional		$2,089.30	$2,691.53	$3,467.37
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 $1,348.96 / $1,995.26 / $3,548.13	Professional		$1,348.96	$1,995.26	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,513.56 / $2,511.89	Professional		$1,318.26	$1,513.56	$2,511.89