Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $5,888.44 / $20,892.96	Facility		$2,884.03	$5,888.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,630.27 / $5,888.44	Professional		$2,089.30	$2,630.27	$5,888.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $2,290.87	Facility		$707.95	$758.58	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,715.35 / $6,918.31	Professional		$2,290.87	$3,715.35	$6,918.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,311.31 / $5,623.41	Facility		$2,187.76	$3,311.31	$5,623.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,467.37 / $5,754.40	Professional		$2,187.76	$3,467.37	$5,754.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $147.91	Professional		$32.36	$33.11	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $4,466.84 / $4,786.30	Facility		$3,467.37	$4,466.84	$4,786.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,235.94	Facility		$3,162.28	$3,162.28	$3,235.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $5,011.87 / $6,918.31	Professional		$3,235.94	$5,011.87	$6,918.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $4,466.84 / $6,025.60	Professional		$3,235.94	$4,466.84	$6,025.60
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 $2,398.83 / $3,467.37 / $6,456.54	Professional		$2,398.83	$3,467.37	$6,456.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,570.40 / $4,265.80	Professional		$2,238.72	$2,570.40	$4,265.80