Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $7,943.28 / $20,892.96	Facility		$1,445.44	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $870.96 / $2,041.74	Professional		$691.83	$870.96	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,071.52 / $1,258.93	Facility		$1,000.00	$1,071.52	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,202.26 / $2,290.87	Professional		$645.65	$1,202.26	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,584.89 / $7,244.36	Facility		$870.96	$1,584.89	$7,244.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,412.54 / $3,801.89	Professional		$724.44	$1,412.54	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,479.11 / $1,548.82	Facility		$1,174.90	$1,479.11	$1,548.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $2,238.72	Professional		$1,047.13	$1,621.81	$2,238.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $16,218.10 / $31,622.78	Facility		$12,022.64	$16,218.10	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,479.11 / $1,949.84	Professional		$1,148.15	$1,479.11	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $19,054.61 / $33,884.42	Facility		$3,235.94	$19,054.61	$33,884.42
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,071.52 / $1,949.84	Professional		$724.44	$1,071.52	$1,949.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $831.76 / $1,380.38	Professional		$724.44	$831.76	$1,380.38