Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $7,762.47 / $20,892.96	Facility		$2,454.71	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,778.28 / $3,801.89	Professional		$1,258.93	$1,778.28	$3,801.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $2,630.27	Facility		$707.95	$870.96	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,398.83 / $4,570.88	Professional		$1,380.38	$2,398.83	$4,570.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,862.09 / $4,168.69	Facility		$1,258.93	$1,862.09	$4,168.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,862.09 / $3,630.78	Professional		$1,258.93	$1,862.09	$3,630.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $676.08	Professional		$32.36	$33.11	$676.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,691.53 / $3,090.30	Facility		$2,041.74	$2,691.53	$3,090.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,041.74 / $2,137.96	Facility		$1,778.28	$2,041.74	$2,137.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,311.31 / $4,466.84	Professional		$2,137.96	$3,311.31	$4,466.84
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 $2,089.30 / $2,884.03 / $3,981.07	Professional		$2,089.30	$2,884.03	$3,981.07
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 $1,513.56 / $2,187.76 / $4,073.80	Professional		$1,513.56	$2,187.76	$4,073.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,698.24 / $2,818.38	Professional		$1,479.11	$1,698.24	$2,818.38