Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $7,762.47 / $20,892.96	Facility		$1,348.96	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $831.76 / $3,467.37	Professional		$630.96	$831.76	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,348.96 / $2,137.96	Professional		$812.83	$1,348.96	$2,137.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,698.24 / $20,892.96	Facility		$954.99	$1,698.24	$20,892.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,548.82 / $5,888.44	Professional		$912.01	$1,548.82	$5,888.44
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 $1,071.52 / $1,380.38 / $1,445.44	Facility		$1,071.52	$1,380.38	$1,445.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Facility		$977.24	$977.24	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,621.81 / $2,089.30	Professional		$977.24	$1,621.81	$2,089.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,454.40 / $21,379.62 / $40,738.03	Facility		$14,454.40	$21,379.62	$40,738.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,380.38 / $1,862.09	Professional		$977.24	$1,380.38	$1,862.09
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $25,703.96 / $44,668.36	Facility		$2,454.71	$25,703.96	$44,668.36
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,122.02 / $2,041.74	Professional		$691.83	$1,122.02	$2,041.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $1,202.26	Professional		$630.96	$851.14	$1,202.26