Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $7,943.28 / $20,892.96	Facility		$4,786.30	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,801.89 / $8,709.64	Professional		$3,162.28	$3,801.89	$8,709.64
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 $2,754.23 / $5,495.41 / $10,471.29	Professional		$2,754.23	$5,495.41	$10,471.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $6,309.57 / $8,912.51	Facility		$3,548.13	$6,309.57	$8,912.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $5,495.41 / $8,912.51	Professional		$3,235.94	$5,495.41	$8,912.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,548.82	Professional		$32.36	$33.11	$1,548.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $6,760.83 / $7,079.46	Facility		$5,011.87	$6,760.83	$7,079.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $7,413.10 / $10,232.93	Professional		$4,786.30	$7,413.10	$10,232.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $6,760.83 / $8,912.51	Professional		$5,370.32	$6,760.83	$8,912.51
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 $3,311.31 / $4,897.79 / $8,912.51	Professional		$3,311.31	$4,897.79	$8,912.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $3,715.35 / $6,165.95	Professional		$3,235.94	$3,715.35	$6,165.95