Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,073.80 / $20,892.96	Facility		$2,818.38	$4,073.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,778.28 / $4,168.69	Professional		$1,479.11	$1,778.28	$4,168.69
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 $1,318.26 / $2,570.40 / $4,897.79	Professional		$1,318.26	$2,570.40	$4,897.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,951.21 / $4,168.69	Facility		$1,659.59	$2,951.21	$4,168.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,630.27 / $4,073.80	Professional		$1,513.56	$2,630.27	$4,073.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,318.26	Professional		$32.36	$33.11	$1,318.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,162.28 / $3,311.31	Facility		$2,290.87	$3,162.28	$3,311.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,290.87 / $6,918.31	Facility		$2,238.72	$2,290.87	$6,918.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,548.13 / $4,786.30	Professional		$2,290.87	$3,548.13	$4,786.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,162.28 / $4,168.69	Professional		$2,511.89	$3,162.28	$4,168.69
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 $1,548.82 / $2,290.87 / $4,168.69	Professional		$1,548.82	$2,290.87	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,737.80 / $2,884.03	Professional		$1,513.56	$1,737.80	$2,884.03