Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,677.35 / $20,892.96	Facility		$2,818.38	$4,677.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $4,786.30	Professional		$1,698.24	$2,137.96	$4,786.30
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 $1,445.44 / $2,951.21 / $5,495.41	Professional		$1,445.44	$2,951.21	$5,495.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,467.37 / $4,897.79	Facility		$1,995.26	$3,467.37	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $3,019.95 / $4,786.30	Professional		$1,737.80	$3,019.95	$4,786.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $812.83	Professional		$32.36	$33.11	$812.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,630.78 / $3,715.35	Facility		$2,818.38	$3,630.78	$3,715.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,511.89	Facility		$2,454.71	$2,454.71	$2,511.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,890.45 / $5,370.32	Professional		$2,511.89	$3,890.45	$5,370.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,548.13 / $4,677.35	Professional		$2,754.23	$3,548.13	$4,677.35
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 $1,778.28 / $2,630.27 / $4,677.35	Professional		$1,778.28	$2,630.27	$4,677.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,949.84 / $3,235.94	Professional		$1,698.24	$1,949.84	$3,235.94