Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $20,892.96	Facility		$1,819.70	$2,630.27	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,148.15 / $2,570.40	Professional		$851.14	$1,148.15	$2,570.40
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 $933.25 / $1,584.89 / $3,019.95	Professional		$933.25	$1,584.89	$3,019.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,348.96 / $2,454.71	Facility		$891.25	$1,348.96	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,479.11 / $2,454.71	Professional		$891.25	$1,479.11	$2,454.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,819.70 / $2,041.74	Facility		$1,445.44	$1,819.70	$2,041.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,380.38	Facility		$1,318.26	$1,318.26	$1,380.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,137.96 / $2,884.03	Professional		$1,380.38	$2,137.96	$2,884.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,905.46 / $2,570.40	Professional		$1,348.96	$1,905.46	$2,570.40
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 $1,000.00 / $1,445.44 / $2,630.27	Professional		$1,000.00	$1,445.44	$2,630.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,148.15 / $1,905.46	Professional		$1,000.00	$1,148.15	$1,905.46