Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $4,265.80 / $18,620.87	Facility		$870.96	$4,265.80	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,479.11 / $3,235.94	Professional		$426.58	$1,479.11	$3,235.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $6,606.93	Facility		$3,981.07	$3,981.07	$6,606.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,513.56 / $4,677.35	Professional		$645.65	$1,513.56	$4,677.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $2,884.03 / $7,585.78	Facility		$645.65	$2,884.03	$7,585.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $2,511.89 / $5,128.61	Professional		$660.69	$2,511.89	$5,128.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,090.30 / $3,548.13	Facility		$2,570.40	$3,090.30	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,344.23 / $2,344.23	Facility		$2,290.87	$2,344.23	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,621.81 / $4,466.84	Professional		$645.65	$1,621.81	$4,466.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $14,125.38 / $26,915.35	Facility		$10,000.00	$14,125.38	$26,915.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $2,041.74 / $4,073.80	Professional		$660.69	$2,041.74	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $17,782.79 / $30,199.52	Facility		$3,467.37	$17,782.79	$30,199.52
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,584.89 / $4,466.84	Professional		$588.84	$1,584.89	$4,466.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $776.25 / $2,344.23	Professional		$407.38	$776.25	$2,344.23