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 / $1,862.09 / $4,168.69	Professional		$1,412.54	$1,862.09	$4,168.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,290.87	Facility		$1,995.26	$1,995.26	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,570.40 / $4,786.30	Professional		$1,548.82	$2,570.40	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,238.72 / $3,890.45	Facility		$1,479.11	$2,238.72	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,398.83 / $3,890.45	Professional		$1,479.11	$2,398.83	$3,890.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,019.95 / $3,235.94	Facility		$2,454.71	$3,019.95	$3,235.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,238.72	Facility		$2,137.96	$2,137.96	$2,238.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,467.37 / $4,677.35	Professional		$2,238.72	$3,467.37	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,019.95 / $4,168.69	Professional		$2,187.76	$3,019.95	$4,168.69
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 $1,621.81 / $2,344.23 / $4,365.16	Professional		$1,621.81	$2,344.23	$4,365.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,778.28 / $2,951.21	Professional		$1,548.82	$1,778.28	$2,951.21