Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,495.41 / $20,892.96	Facility		$3,090.30	$5,495.41	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,454.71 / $5,623.41	Professional		$1,995.26	$2,454.71	$5,623.41
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 $1,698.24 / $3,548.13 / $6,760.83	Professional		$1,698.24	$3,548.13	$6,760.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $4,073.80 / $5,754.40	Facility		$2,187.76	$4,073.80	$5,754.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,467.37 / $5,623.41	Professional		$2,089.30	$3,467.37	$5,623.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,023.29	Professional		$32.36	$33.11	$1,023.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,073.80 / $4,570.88	Facility		$3,019.95	$4,073.80	$4,570.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,162.28	Facility		$3,090.30	$3,090.30	$3,162.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,897.79 / $6,760.83	Professional		$3,162.28	$4,897.79	$6,760.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $5,754.40	Professional		$3,311.31	$4,365.16	$5,754.40
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 $2,137.96 / $3,090.30 / $5,754.40	Professional		$2,137.96	$3,090.30	$5,754.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,454.71 / $4,073.80	Professional		$2,137.96	$2,454.71	$4,073.80