Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,951.21 / $20,892.96	Facility		$2,187.76	$2,951.21	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,258.93 / $2,951.21	Professional		$1,023.29	$1,258.93	$2,951.21
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 $891.25 / $1,819.70 / $3,467.37	Professional		$891.25	$1,819.70	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $2,089.30 / $2,884.03	Facility		$1,122.02	$2,089.30	$2,884.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,819.70 / $2,818.38	Professional		$1,047.13	$1,819.70	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $512.86	Professional		$32.36	$33.11	$512.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,187.76 / $2,344.23	Facility		$1,584.89	$2,187.76	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,621.81	Facility		$1,548.82	$1,548.82	$1,621.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,454.71 / $3,467.37	Professional		$1,621.81	$2,454.71	$3,467.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,187.76 / $2,884.03	Professional		$1,737.80	$2,187.76	$2,884.03
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 $1,071.52 / $1,584.89 / $2,884.03	Professional		$1,071.52	$1,584.89	$2,884.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,288.25 / $2,137.96	Professional		$1,122.02	$1,288.25	$2,137.96