Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,884.03 / $20,892.96	Facility		$2,137.96	$2,884.03	$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 $912.01 / $1,819.70 / $3,388.44	Professional		$912.01	$1,819.70	$3,388.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $2,089.30 / $2,884.03	Facility		$1,148.15	$2,089.30	$2,884.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,862.09 / $2,884.03	Professional		$1,071.52	$1,862.09	$2,884.03
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 / $2,187.76 / $2,290.87	Facility		$1,621.81	$2,187.76	$2,290.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,584.89	Facility		$1,548.82	$1,548.82	$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 $1,737.80 / $2,187.76 / $2,884.03	Professional		$1,737.80	$2,187.76	$2,884.03
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 $1,096.48 / $1,584.89 / $2,951.21	Professional		$1,096.48	$1,584.89	$2,951.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,230.27 / $2,041.74	Professional		$1,071.52	$1,230.27	$2,041.74