Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,370.32 / $20,892.96	Facility		$2,951.21	$5,370.32	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,398.83 / $5,248.07	Professional		$1,905.46	$2,398.83	$5,248.07
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 $1,698.24 / $3,388.44 / $6,309.57	Professional		$1,698.24	$3,388.44	$6,309.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,890.45 / $5,370.32	Facility		$2,187.76	$3,890.45	$5,370.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,388.44 / $5,370.32	Professional		$1,995.26	$3,388.44	$5,370.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $933.25	Professional		$32.36	$33.11	$933.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,073.80 / $4,265.80	Facility		$3,019.95	$4,073.80	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,951.21	Facility		$2,884.03	$2,884.03	$2,951.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,570.88 / $6,309.57	Professional		$2,951.21	$4,570.88	$6,309.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $4,168.69 / $5,370.32	Professional		$3,235.94	$4,168.69	$5,370.32
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 $1,995.26 / $3,019.95 / $5,495.41	Professional		$1,995.26	$3,019.95	$5,495.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,290.87 / $3,801.89	Professional		$1,995.26	$2,290.87	$3,801.89