Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $6,025.60 / $18,620.87	Facility		$1,258.93	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $724.44 / $1,659.59	Professional		$588.84	$724.44	$1,659.59
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 $575.44 / $1,023.29 / $1,995.26	Professional		$575.44	$1,023.29	$1,995.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,348.96 / $4,168.69	Facility		$741.31	$1,348.96	$4,168.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,202.26 / $2,187.76	Professional		$588.84	$1,202.26	$2,187.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $295.12	Professional		$32.36	$33.11	$295.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,230.27 / $1,348.96	Facility		$1,000.00	$1,230.27	$1,348.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $933.25 / $2,691.53	Facility		$912.01	$933.25	$2,691.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,445.44 / $1,995.26	Professional		$933.25	$1,445.44	$1,995.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $9,772.37 / $18,620.87	Facility		$7,079.46	$9,772.37	$18,620.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,288.25 / $1,698.24	Professional		$977.24	$1,288.25	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $11,220.18 / $19,952.62	Facility		$2,137.96	$11,220.18	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $912.01 / $1,698.24	Professional		$630.96	$912.01	$1,698.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $724.44 / $1,202.26	Professional		$630.96	$724.44	$1,202.26