Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $6,025.60 / $18,620.87	Facility		$2,187.76	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,380.38 / $3,090.30	Professional		$1,047.13	$1,380.38	$3,090.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $676.08 / $2,187.76	Facility		$630.96	$676.08	$2,187.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,905.46 / $3,548.13	Professional		$1,071.52	$1,905.46	$3,548.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $3,235.94	Facility		$1,148.15	$1,778.28	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $2,884.03	Professional		$1,148.15	$1,778.28	$2,884.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $512.86	Professional		$32.36	$33.11	$512.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,238.72 / $2,344.23	Facility		$1,778.28	$2,238.72	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,621.81	Facility		$1,584.89	$1,584.89	$1,621.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,511.89 / $3,388.44	Professional		$1,621.81	$2,511.89	$3,388.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $5,623.41 / $10,471.29	Facility		$4,168.69	$5,623.41	$10,471.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,238.72 / $3,019.95	Professional		$1,621.81	$2,238.72	$3,019.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $6,918.31 / $12,882.50	Facility		$2,454.71	$6,918.31	$12,882.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,778.28 / $3,235.94	Professional		$1,174.90	$1,778.28	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,230.27 / $1,995.26	Professional		$1,071.52	$1,230.27	$1,995.26