Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,073.80 / $20,892.96	Facility		$2,818.38	$4,073.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,819.70 / $4,073.80	Professional		$1,412.54	$1,819.70	$4,073.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $7,244.36 / $7,244.36	Facility		$7,244.36	$7,244.36	$7,244.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,019.95 / $4,786.30	Professional		$1,949.84	$3,019.95	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,630.78 / $16,982.44	Facility		$2,041.74	$3,630.78	$16,982.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,467.37 / $4,570.88	Professional		$2,041.74	$3,467.37	$4,570.88
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 $2,511.89 / $3,090.30 / $3,311.31	Facility		$2,511.89	$3,090.30	$3,311.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,238.72 / $2,238.72	Facility		$2,187.76	$2,238.72	$2,238.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,715.35 / $4,786.30	Professional		$2,238.72	$3,715.35	$4,786.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $19,054.61 / $36,307.81	Facility		$12,882.50	$19,054.61	$36,307.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,162.28 / $4,265.80	Professional		$2,238.72	$3,162.28	$4,265.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $12,589.25 / $20,417.38	Facility		$3,467.37	$12,589.25	$20,417.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,570.40 / $4,677.35	Professional		$1,584.89	$2,570.40	$4,677.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,089.30 / $2,951.21	Professional		$1,548.82	$2,089.30	$2,951.21