Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $7,943.28 / $20,892.96	Facility		$2,398.83	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $3,235.94	Professional		$1,148.15	$1,380.38	$3,235.94
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 $1,071.52 / $2,041.74 / $3,801.89	Professional		$1,071.52	$2,041.74	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,290.87 / $3,235.94	Facility		$1,288.25	$2,290.87	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $3,235.94	Professional		$1,202.26	$2,041.74	$3,235.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $562.34	Professional		$32.36	$33.11	$562.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,454.71 / $2,570.40	Facility		$2,089.30	$2,454.71	$2,570.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $6,918.31	Facility		$1,737.80	$1,737.80	$6,918.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,691.53 / $3,715.35	Professional		$1,737.80	$2,691.53	$3,715.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $24,547.09 / $24,547.09	Facility		$5,011.87	$24,547.09	$24,547.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,454.71 / $3,235.94	Professional		$1,949.84	$2,454.71	$3,235.94
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $4,466.84 / $7,079.46	Facility		$2,137.96	$4,466.84	$7,079.46
United Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,778.28 / $3,311.31	Professional		$1,202.26	$1,778.28	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,380.38 / $2,238.72	Professional		$1,202.26	$1,380.38	$2,238.72