Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,754.40 / $20,892.96	Facility		$3,090.30	$5,754.40	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,570.40 / $5,754.40	Professional		$2,041.74	$2,570.40	$5,754.40
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 $1,862.09 / $3,630.78 / $6,760.83	Professional		$1,862.09	$3,630.78	$6,760.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $4,168.69 / $5,754.40	Facility		$2,187.76	$4,168.69	$5,754.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,630.78 / $5,754.40	Professional		$2,137.96	$3,630.78	$5,754.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,000.00	Professional		$32.36	$33.11	$1,000.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $4,677.35	Facility		$3,311.31	$4,365.16	$4,677.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,162.28	Facility		$3,090.30	$3,090.30	$3,162.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,897.79 / $6,760.83	Professional		$3,162.28	$4,897.79	$6,760.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,466.84 / $5,754.40	Professional		$3,467.37	$4,466.84	$5,754.40
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 $2,137.96 / $3,235.94 / $5,888.44	Professional		$2,137.96	$3,235.94	$5,888.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,398.83 / $3,981.07	Professional		$2,089.30	$2,398.83	$3,981.07