Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $3,801.89 / $20,892.96	Facility		$2,754.23	$3,801.89	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,737.80 / $3,801.89	Professional		$1,288.25	$1,737.80	$3,801.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $870.96	Facility		$758.58	$758.58	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,344.23 / $4,466.84	Professional		$1,412.54	$2,344.23	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,089.30 / $3,548.13	Facility		$1,412.54	$2,089.30	$3,548.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,187.76 / $3,715.35	Professional		$1,445.44	$2,187.76	$3,715.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,818.38 / $2,951.21	Facility		$2,290.87	$2,818.38	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,041.74	Facility		$1,995.26	$1,995.26	$2,041.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,162.28 / $4,168.69	Professional		$1,995.26	$3,162.28	$4,168.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $10,000.00 / $10,000.00	Facility		$10,000.00	$10,000.00	$10,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,818.38 / $3,801.89	Professional		$2,041.74	$2,818.38	$3,801.89
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,318.26 / $5,754.40	Facility		$707.95	$1,318.26	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,290.87 / $4,168.69	Professional		$1,513.56	$2,290.87	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,513.56 / $2,454.71	Professional		$1,318.26	$1,513.56	$2,454.71