Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $7,943.28 / $20,892.96	Facility		$1,288.25	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $891.25 / $2,089.30	Professional		$630.96	$891.25	$2,089.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $2,290.87	Facility		$1,380.38	$1,380.38	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,288.25 / $2,041.74	Professional		$831.76	$1,288.25	$2,041.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,548.82 / $6,025.60	Facility		$891.25	$1,548.82	$6,025.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,479.11 / $2,041.74	Professional		$870.96	$1,479.11	$2,041.74
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 $1,122.02 / $1,348.96 / $1,380.38	Facility		$1,122.02	$1,348.96	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $933.25	Facility		$912.01	$912.01	$933.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,548.82 / $1,995.26	Professional		$933.25	$1,548.82	$1,995.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $5,754.40 / $10,964.78	Facility		$4,168.69	$5,754.40	$10,964.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,318.26 / $1,778.28	Professional		$933.25	$1,318.26	$1,778.28
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 $691.83 / $1,122.02 / $1,949.84	Professional		$691.83	$1,122.02	$1,949.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $1,202.26	Professional		$630.96	$851.14	$1,202.26