Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $6,025.60 / $18,620.87	Facility		$1,621.81	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,071.52 / $2,570.40	Professional		$831.76	$1,071.52	$2,570.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $6,025.60	Facility		$6,025.60	$6,025.60	$6,025.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $2,630.27	Professional		$1,047.13	$1,621.81	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $2,041.74 / $13,182.57	Facility		$1,148.15	$2,041.74	$13,182.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,949.84 / $4,897.79	Professional		$1,096.48	$1,949.84	$4,897.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,698.24 / $1,737.80	Facility		$1,445.44	$1,698.24	$1,737.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,202.26 / $1,202.26	Facility		$1,148.15	$1,202.26	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,949.84 / $2,570.40	Professional		$1,202.26	$1,949.84	$2,570.40
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 $1,174.90 / $1,659.59 / $2,238.72	Professional		$1,174.90	$1,659.59	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $18,620.87 / $32,359.37	Facility		$2,454.71	$18,620.87	$32,359.37
United Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,412.54 / $2,511.89	Professional		$870.96	$1,412.54	$2,511.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,071.52 / $1,513.56	Professional		$794.33	$1,071.52	$1,513.56