Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $7,762.47 / $20,892.96	Facility		$1,513.56	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $870.96 / $2,754.23	Professional		$676.08	$870.96	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,513.56 / $2,454.71	Professional		$933.25	$1,513.56	$2,454.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,659.59 / $2,041.74	Facility		$954.99	$1,659.59	$2,041.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,659.59 / $2,089.30	Professional		$1,023.29	$1,659.59	$2,089.30
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 $1,174.90 / $1,548.82 / $1,659.59	Facility		$1,174.90	$1,548.82	$1,659.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,122.02	Facility		$1,096.48	$1,096.48	$1,122.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,862.09 / $2,398.83	Professional		$1,122.02	$1,862.09	$2,398.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,584.89 / $2,137.96	Professional		$1,122.02	$1,584.89	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,388.44 / $7,244.36	Facility		$2,454.71	$3,388.44	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,258.93 / $2,344.23	Professional		$776.25	$1,258.93	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $977.24 / $1,380.38	Professional		$724.44	$977.24	$1,380.38