Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,168.69 / $20,892.96	Facility		$2,818.38	$4,168.69	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,949.84 / $4,265.80	Professional		$1,445.44	$1,949.84	$4,265.80
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 $1,548.82 / $2,691.53 / $5,011.87	Professional		$1,548.82	$2,691.53	$5,011.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,344.23 / $4,073.80	Facility		$1,513.56	$2,344.23	$4,073.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,454.71 / $4,073.80	Professional		$1,548.82	$2,454.71	$4,073.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,162.28 / $3,388.44	Facility		$2,344.23	$3,162.28	$3,388.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,344.23	Facility		$2,238.72	$2,238.72	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,630.78 / $4,897.79	Professional		$2,344.23	$3,630.78	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,162.28 / $4,365.16	Professional		$2,290.87	$3,162.28	$4,365.16
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 $1,659.59 / $2,454.71 / $4,466.84	Professional		$1,659.59	$2,454.71	$4,466.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,905.46 / $3,090.30	Professional		$1,621.81	$1,905.46	$3,090.30