Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $6,025.60 / $18,620.87	Facility		$2,089.30	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,202.26 / $2,884.03	Professional		$1,000.00	$1,202.26	$2,884.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $3,981.07	Facility		$630.96	$758.58	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,737.80 / $3,311.31	Professional		$851.14	$1,737.80	$3,311.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,238.72 / $3,715.35	Facility		$1,258.93	$2,238.72	$3,715.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,905.46 / $3,019.95	Professional		$1,047.13	$1,905.46	$3,019.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $489.78	Professional		$32.36	$33.11	$489.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,137.96 / $2,238.72	Facility		$1,548.82	$2,137.96	$2,238.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,513.56 / $1,995.26	Facility		$1,479.11	$1,513.56	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,344.23 / $3,235.94	Professional		$1,513.56	$2,344.23	$3,235.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $7,943.28 / $15,135.61	Facility		$5,754.40	$7,943.28	$15,135.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,089.30 / $2,754.23	Professional		$1,621.81	$2,089.30	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $8,709.64 / $15,488.17	Facility		$2,137.96	$8,709.64	$15,488.17
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,513.56 / $2,754.23	Professional		$1,023.29	$1,513.56	$2,754.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,230.27 / $1,995.26	Professional		$1,047.13	$1,230.27	$1,995.26