Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $4,677.35 / $21,877.62	Facility		$2,290.87	$4,677.35	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,318.26 / $3,467.37	Professional		$977.24	$1,318.26	$3,467.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,122.02	Facility		$645.65	$645.65	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,137.96 / $3,890.45	Professional		$1,258.93	$2,137.96	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,290.87 / $3,090.30	Facility		$1,412.54	$2,290.87	$3,090.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,290.87 / $3,090.30	Professional		$1,412.54	$2,290.87	$3,090.30
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 $1,949.84 / $2,691.53 / $2,951.21	Facility		$1,949.84	$2,691.53	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,995.26	Facility		$1,445.44	$1,445.44	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $4,265.80	Professional		$1,819.70	$2,630.27	$4,265.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,089.30 / $3,630.78	Professional		$1,258.93	$2,089.30	$3,630.78
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,318.26 / $5,754.40	Facility		$602.56	$1,318.26	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,698.24 / $3,162.28	Professional		$1,348.96	$1,698.24	$3,162.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,513.56 / $2,454.71	Professional		$1,288.25	$1,513.56	$2,454.71