Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,248.07 / $20,892.96	Facility		$2,951.21	$5,248.07	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,398.83 / $5,623.41	Professional		$1,905.46	$2,398.83	$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 $1,659.59 / $3,388.44 / $6,456.54	Professional		$1,659.59	$3,388.44	$6,456.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $3,890.45 / $5,370.32	Facility		$2,089.30	$3,890.45	$5,370.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,311.31 / $5,370.32	Professional		$1,949.84	$3,311.31	$5,370.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $954.99	Professional		$32.36	$33.11	$954.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,073.80 / $4,365.16	Facility		$3,019.95	$4,073.80	$4,365.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Facility		$2,951.21	$2,951.21	$2,951.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,570.88 / $6,309.57	Professional		$2,951.21	$4,570.88	$6,309.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,168.69 / $5,495.41	Professional		$3,311.31	$4,168.69	$5,495.41
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 $2,041.74 / $2,951.21 / $5,495.41	Professional		$2,041.74	$2,951.21	$5,495.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,344.23 / $3,890.45	Professional		$2,041.74	$2,344.23	$3,890.45