Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,365.16 / $20,892.96	Facility		$2,818.38	$4,365.16	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,949.84 / $4,265.80	Professional		$1,548.82	$1,949.84	$4,265.80
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 $1,412.54 / $2,754.23 / $5,128.61	Professional		$1,412.54	$2,754.23	$5,128.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,090.30 / $4,365.16	Facility		$1,659.59	$3,090.30	$4,365.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,754.23 / $4,365.16	Professional		$1,621.81	$2,754.23	$4,365.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $758.58	Professional		$32.36	$33.11	$758.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $3,311.31 / $3,548.13	Facility		$2,511.89	$3,311.31	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,398.83	Facility		$2,344.23	$2,344.23	$2,398.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,715.35 / $5,128.61	Professional		$2,398.83	$3,715.35	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,388.44 / $4,365.16	Professional		$2,511.89	$3,388.44	$4,365.16
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 $1,621.81 / $2,398.83 / $4,466.84	Professional		$1,621.81	$2,398.83	$4,466.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,862.09 / $3,019.95	Professional		$1,621.81	$1,862.09	$3,019.95