Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $4,265.80 / $20,892.96	Facility		$2,754.23	$4,265.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,905.46 / $4,365.16	Professional		$1,513.56	$1,905.46	$4,365.16
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 $1,621.81 / $2,754.23 / $5,128.61	Professional		$1,621.81	$2,754.23	$5,128.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,398.83 / $4,168.69	Facility		$1,584.89	$2,398.83	$4,168.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,570.40 / $4,168.69	Professional		$1,584.89	$2,570.40	$4,168.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,019.95 / $3,467.37	Facility		$2,344.23	$3,019.95	$3,467.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,398.83	Facility		$2,290.87	$2,290.87	$2,398.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,715.35 / $5,011.87	Professional		$2,398.83	$3,715.35	$5,011.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,235.94 / $4,466.84	Professional		$2,344.23	$3,235.94	$4,466.84
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 $1,737.80 / $2,511.89 / $4,677.35	Professional		$1,737.80	$2,511.89	$4,677.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,905.46 / $3,090.30	Professional		$1,659.59	$1,905.46	$3,090.30