Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,951.21 / $20,892.96	Facility		$2,137.96	$2,951.21	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,288.25 / $2,951.21	Professional		$1,047.13	$1,288.25	$2,951.21
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 $933.25 / $1,819.70 / $3,467.37	Professional		$933.25	$1,819.70	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,089.30 / $2,951.21	Facility		$1,174.90	$2,089.30	$2,951.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,862.09 / $2,951.21	Professional		$1,071.52	$1,862.09	$2,951.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $512.86	Professional		$32.36	$33.11	$512.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,238.72 / $2,344.23	Facility		$1,621.81	$2,238.72	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,454.71 / $3,388.44	Professional		$1,584.89	$2,454.71	$3,388.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,238.72 / $2,951.21	Professional		$1,778.28	$2,238.72	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $812.83 / $3,311.31	Facility		$794.33	$812.83	$3,311.31
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $2,951.21	Professional		$1,096.48	$1,621.81	$2,951.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,258.93 / $2,089.30	Professional		$1,096.48	$1,258.93	$2,089.30