Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $5,248.07 / $20,892.96	Facility		$2,884.03	$5,248.07	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,344.23 / $5,128.61	Professional		$1,905.46	$2,344.23	$5,128.61
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 $1,659.59 / $3,311.31 / $6,165.95	Professional		$1,659.59	$3,311.31	$6,165.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,801.89 / $5,370.32	Facility		$1,995.26	$3,801.89	$5,370.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,311.31 / $5,248.07	Professional		$1,949.84	$3,311.31	$5,248.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $933.25	Professional		$32.36	$33.11	$933.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,073.80 / $4,265.80	Facility		$3,019.95	$4,073.80	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility		$2,884.03	$2,884.03	$2,884.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,466.84 / $6,165.95	Professional		$2,884.03	$4,466.84	$6,165.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,073.80 / $5,370.32	Professional		$3,162.28	$4,073.80	$5,370.32
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 $1,949.84 / $2,951.21 / $5,370.32	Professional		$1,949.84	$2,951.21	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,238.72 / $3,630.78	Professional		$1,905.46	$2,238.72	$3,630.78