Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $6,025.60 / $18,620.87	Facility		$1,905.46	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,202.26 / $2,754.23	Professional		$954.99	$1,202.26	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,905.46 / $3,019.95	Professional		$1,202.26	$1,905.46	$3,019.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,187.76 / $6,606.93	Facility		$1,288.25	$2,187.76	$6,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,089.30 / $2,630.27	Professional		$1,258.93	$2,089.30	$2,630.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,949.84 / $2,041.74	Facility		$1,548.82	$1,949.84	$2,041.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,380.38	Facility		$1,348.96	$1,348.96	$1,380.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,290.87 / $2,951.21	Professional		$1,380.38	$2,290.87	$2,951.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $5,754.40 / $10,964.78	Facility		$4,365.16	$5,754.40	$10,964.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,949.84 / $2,630.27	Professional		$1,380.38	$1,949.84	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $7,762.47 / $12,589.25	Facility		$1,995.26	$7,762.47	$12,589.25
United Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,621.81 / $2,884.03	Professional		$1,000.00	$1,621.81	$2,884.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $1,737.80	Professional		$912.01	$1,230.27	$1,737.80