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 $1,737.80 / $2,137.96 / $4,897.79	Professional		$1,737.80	$2,137.96	$4,897.79
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 $1,479.11 / $3,090.30 / $5,888.44	Professional		$1,479.11	$3,090.30	$5,888.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $3,548.13 / $5,011.87	Facility		$1,949.84	$3,548.13	$5,011.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,019.95 / $4,897.79	Professional		$1,819.70	$3,019.95	$4,897.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $891.25	Professional		$32.36	$33.11	$891.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,630.78 / $3,981.07	Facility		$2,691.53	$3,630.78	$3,981.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,754.23	Facility		$2,691.53	$2,691.53	$2,754.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,265.80 / $5,888.44	Professional		$2,754.23	$4,265.80	$5,888.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,801.89 / $5,011.87	Professional		$3,019.95	$3,801.89	$5,011.87
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 $1,862.09 / $2,691.53 / $5,011.87	Professional		$1,862.09	$2,691.53	$5,011.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,187.76 / $3,630.78	Professional		$1,905.46	$2,187.76	$3,630.78