Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $3,630.78 / $20,892.96	Facility		$2,511.89	$3,630.78	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $3,630.78	Professional		$1,258.93	$1,621.81	$3,630.78
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 $1,348.96 / $2,290.87 / $4,365.16	Professional		$1,348.96	$2,290.87	$4,365.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,995.26 / $3,467.37	Facility		$1,318.26	$1,995.26	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,137.96 / $3,548.13	Professional		$1,318.26	$2,137.96	$3,548.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,691.53 / $2,951.21	Facility		$2,089.30	$2,691.53	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,995.26	Facility		$1,949.84	$1,949.84	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,090.30 / $4,168.69	Professional		$1,995.26	$3,090.30	$4,168.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,754.23 / $3,715.35	Professional		$1,995.26	$2,754.23	$3,715.35
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 $1,445.44 / $2,089.30 / $3,890.45	Professional		$1,445.44	$2,089.30	$3,890.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,621.81 / $2,691.53	Professional		$1,412.54	$1,621.81	$2,691.53