Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $7,762.47 / $20,892.96	Facility		$2,344.23	$7,762.47	$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 $1,445.44 / $2,630.27 / $7,244.36	Facility		$1,445.44	$2,630.27	$7,244.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,344.23 / $4,265.80	Professional		$1,202.26	$2,344.23	$4,265.80
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 / $4,073.80	Facility		$1,737.80	$1,737.80	$4,073.80
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 $12,589.25 / $16,595.87 / $31,622.78	Facility		$12,589.25	$16,595.87	$31,622.78
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 $2,884.03 / $17,782.79 / $33,884.42	Facility		$2,884.03	$17,782.79	$33,884.42
United Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,778.28 / $3,235.94	Professional		$1,202.26	$1,778.28	$3,235.94
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