Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,162.28 / $20,892.96	Facility		$2,344.23	$3,162.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,412.54 / $3,090.30	Professional		$1,148.15	$1,412.54	$3,090.30
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 $1,000.00 / $1,995.26 / $3,715.35	Professional		$1,000.00	$1,995.26	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,187.76 / $3,162.28	Facility		$1,202.26	$2,187.76	$3,162.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,949.84 / $3,162.28	Professional		$1,174.90	$1,949.84	$3,162.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $562.34	Professional		$32.36	$33.11	$562.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,344.23 / $2,570.40	Facility		$1,737.80	$2,344.23	$2,570.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,691.53 / $3,715.35	Professional		$1,737.80	$2,691.53	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,454.71 / $3,162.28	Professional		$1,905.46	$2,454.71	$3,162.28
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 $1,202.26 / $1,778.28 / $3,235.94	Professional		$1,202.26	$1,778.28	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,380.38 / $2,290.87	Professional		$1,202.26	$1,380.38	$2,290.87