Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $6,025.60 / $18,620.87	Facility		$1,513.56	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $954.99 / $2,290.87	Professional		$707.95	$954.99	$2,290.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $4,466.84	Facility		$630.96	$758.58	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,288.25 / $2,398.83	Professional		$707.95	$1,288.25	$2,398.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,621.81 / $4,265.80	Facility		$851.14	$1,621.81	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,584.89 / $2,818.38	Professional		$776.25	$1,584.89	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $363.08	Professional		$32.36	$33.11	$363.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,513.56 / $1,621.81	Facility		$1,202.26	$1,513.56	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,096.48	Facility		$1,071.52	$1,071.52	$1,096.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,698.24 / $2,290.87	Professional		$1,096.48	$1,698.24	$2,290.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $9,120.11 / $17,378.01	Facility		$6,165.95	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,513.56 / $2,041.74	Professional		$1,096.48	$1,513.56	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $11,220.18 / $18,620.87	Facility		$2,454.71	$11,220.18	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,174.90 / $2,187.76	Professional		$794.33	$1,174.90	$2,187.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $851.14 / $1,412.54	Professional		$741.31	$851.14	$1,412.54