Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $7,943.28 / $20,892.96	Facility		$1,380.38	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $2,089.30	Professional		$630.96	$851.14	$2,089.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $6,760.83	Facility		$4,073.80	$4,073.80	$6,760.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,380.38 / $2,187.76	Professional		$851.14	$1,380.38	$2,187.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,737.80 / $15,488.17	Facility		$1,000.00	$1,737.80	$15,488.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,584.89 / $5,495.41	Professional		$933.25	$1,584.89	$5,495.41
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 $1,174.90 / $1,412.54 / $1,479.11	Facility		$1,174.90	$1,412.54	$1,479.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,000.00 / $1,000.00	Facility		$977.24	$1,000.00	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,659.59 / $2,137.96	Professional		$1,000.00	$1,659.59	$2,137.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $16,218.10 / $31,622.78	Facility		$10,715.19	$16,218.10	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $1,905.46	Professional		$1,000.00	$1,412.54	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $20,892.96 / $36,307.81	Facility		$4,265.80	$20,892.96	$36,307.81
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,148.15 / $2,089.30	Professional		$707.95	$1,148.15	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $870.96 / $1,230.27	Professional		$645.65	$870.96	$1,230.27