Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $7,762.47 / $20,892.96	Facility		$1,071.52	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $1,995.26	Professional		$489.78	$660.69	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Facility		$3,162.28	$3,162.28	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,071.52 / $1,737.80	Professional		$630.96	$1,071.52	$1,737.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,348.96 / $13,803.84	Facility		$707.95	$1,348.96	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,230.27 / $4,168.69	Professional		$707.95	$1,230.27	$4,168.69
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 $870.96 / $1,071.52 / $1,148.15	Facility		$870.96	$1,071.52	$1,148.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $776.25 / $776.25	Facility		$758.58	$776.25	$776.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,288.25 / $1,659.59	Professional		$776.25	$1,288.25	$1,659.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,549.93 / $14,125.38 / $26,915.35	Facility		$9,549.93	$14,125.38	$26,915.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,096.48 / $1,479.11	Professional		$776.25	$1,096.48	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $17,378.01 / $30,199.52	Facility		$2,454.71	$17,378.01	$30,199.52
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $870.96 / $1,584.89	Professional		$537.03	$870.96	$1,584.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $676.08 / $954.99	Professional		$501.19	$676.08	$954.99