Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $3,388.44 / $20,892.96	Facility		$2,511.89	$3,388.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,513.56 / $3,311.31	Professional		$1,230.27	$1,513.56	$3,311.31
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 $1,096.48 / $2,137.96 / $4,073.80	Professional		$1,096.48	$2,137.96	$4,073.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $2,454.71 / $3,467.37	Facility		$1,380.38	$2,454.71	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,187.76 / $3,467.37	Professional		$1,288.25	$2,187.76	$3,467.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $602.56	Professional		$32.36	$33.11	$602.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,630.27 / $2,754.23	Facility		$1,949.84	$2,630.27	$2,754.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility		$1,862.09	$1,862.09	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,884.03 / $3,981.07	Professional		$1,862.09	$2,884.03	$3,981.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,630.27 / $3,467.37	Professional		$2,089.30	$2,630.27	$3,467.37
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 $1,288.25 / $1,905.46 / $3,467.37	Professional		$1,288.25	$1,905.46	$3,467.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,445.44 / $2,398.83	Professional		$1,258.93	$1,445.44	$2,398.83