Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,548.13 / $18,620.87	Facility		$1,122.02	$3,548.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $741.31 / $1,737.80	Professional		$562.34	$741.31	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $6,025.60	Facility		$3,548.13	$3,548.13	$6,025.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,122.02 / $1,778.28	Professional		$724.44	$1,122.02	$1,778.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,412.54 / $13,182.57	Facility		$794.33	$1,412.54	$13,182.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,318.26 / $4,897.79	Professional		$758.58	$1,318.26	$4,897.79
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 $977.24 / $1,174.90 / $1,202.26	Facility		$977.24	$1,174.90	$1,202.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $812.83 / $812.83	Facility		$794.33	$812.83	$812.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,348.96 / $1,737.80	Professional		$812.83	$1,348.96	$1,737.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,772.37 / $14,791.08 / $28,183.83	Facility		$9,772.37	$14,791.08	$28,183.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,148.15 / $1,548.82	Professional		$812.83	$1,148.15	$1,548.82
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $18,620.87 / $32,359.37	Facility		$1,698.24	$18,620.87	$32,359.37
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $977.24 / $1,698.24	Professional		$602.56	$977.24	$1,698.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $1,000.00	Professional		$524.81	$707.95	$1,000.00