Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $3,311.31 / $20,892.96	Facility		$2,398.83	$3,311.31	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,445.44 / $3,311.31	Professional		$1,174.90	$1,445.44	$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 $1,071.52 / $2,041.74 / $3,890.45	Professional		$1,071.52	$2,041.74	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,344.23 / $3,311.31	Facility		$1,230.27	$2,344.23	$3,311.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,089.30 / $3,311.31	Professional		$1,230.27	$2,089.30	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $575.44	Professional		$32.36	$33.11	$575.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,511.89 / $2,630.27	Facility		$1,862.09	$2,511.89	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,754.23 / $3,801.89	Professional		$1,778.28	$2,754.23	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,511.89 / $3,311.31	Professional		$1,995.26	$2,511.89	$3,311.31
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 $1,230.27 / $1,819.70 / $3,311.31	Professional		$1,230.27	$1,819.70	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,380.38 / $2,290.87	Professional		$1,202.26	$1,380.38	$2,290.87