Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,890.45 / $20,892.96	Facility		$2,818.38	$3,890.45	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,698.24 / $3,890.45	Professional		$1,412.54	$1,698.24	$3,890.45
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 $1,348.96 / $2,398.83 / $4,466.84	Professional		$1,348.96	$2,398.83	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,691.53 / $3,890.45	Facility		$1,584.89	$2,691.53	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,398.83 / $3,801.89	Professional		$1,412.54	$2,398.83	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $660.69	Professional		$32.36	$33.11	$660.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,884.03 / $3,090.30	Facility		$2,187.76	$2,884.03	$3,090.30
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 $2,290.87 / $2,951.21 / $3,801.89	Professional		$2,290.87	$2,951.21	$3,801.89
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $7,079.46 / $11,481.54	Facility		$3,235.94	$7,079.46	$11,481.54
United Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,137.96 / $3,890.45	Professional		$1,412.54	$2,137.96	$3,890.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,621.81 / $2,630.27	Professional		$1,412.54	$1,621.81	$2,630.27