Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,019.95 / $20,892.96	Facility		$2,238.72	$3,019.95	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,348.96 / $3,090.30	Professional		$1,071.52	$1,348.96	$3,090.30
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 $977.24 / $1,905.46 / $3,548.13	Professional		$977.24	$1,905.46	$3,548.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,137.96 / $3,019.95	Facility		$1,202.26	$2,137.96	$3,019.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,905.46 / $3,019.95	Professional		$1,122.02	$1,905.46	$3,019.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $537.03	Professional		$32.36	$33.11	$537.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,290.87 / $2,454.71	Facility		$1,698.24	$2,290.87	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,659.59	Facility		$1,621.81	$1,621.81	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,570.40 / $3,548.13	Professional		$1,659.59	$2,570.40	$3,548.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,344.23 / $3,019.95	Professional		$1,819.70	$2,344.23	$3,019.95
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 $1,122.02 / $1,659.59 / $3,090.30	Professional		$1,122.02	$1,659.59	$3,090.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,288.25 / $2,137.96	Professional		$1,122.02	$1,288.25	$2,137.96