Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,778.28 / $20,892.96	Facility		$1,288.25	$1,778.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $1,862.09	Professional		$630.96	$794.33	$1,862.09
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 $616.60 / $1,096.48 / $2,041.74	Professional		$616.60	$1,096.48	$2,041.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,258.93 / $1,737.80	Facility		$676.08	$1,258.93	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,096.48 / $1,737.80	Professional		$645.65	$1,096.48	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,318.26 / $1,380.38	Facility		$1,000.00	$1,318.26	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $954.99	Facility		$933.25	$933.25	$954.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,479.11 / $2,089.30	Professional		$954.99	$1,479.11	$2,089.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $1,737.80	Professional		$1,047.13	$1,318.26	$1,737.80
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 $660.69 / $977.24 / $1,737.80	Professional		$660.69	$977.24	$1,737.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $776.25 / $1,288.25	Professional		$676.08	$776.25	$1,288.25