Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $6,025.60 / $18,620.87	Facility		$2,041.74	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,318.26 / $3,388.44	Professional		$977.24	$1,318.26	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $11,220.18	Facility		$630.96	$758.58	$11,220.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,737.80 / $3,235.94	Professional		$977.24	$1,737.80	$3,235.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $2,187.76 / $12,022.64	Facility		$1,096.48	$2,187.76	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $2,137.96 / $9,549.93	Professional		$1,096.48	$2,137.96	$9,549.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $81.28	Professional		$32.36	$33.11	$81.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,089.30 / $2,187.76	Facility		$1,584.89	$2,089.30	$2,187.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,479.11 / $2,344.23	Facility		$1,445.44	$1,479.11	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,290.87 / $3,090.30	Professional		$1,479.11	$2,290.87	$3,090.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $19,054.61 / $36,307.81	Facility		$12,882.50	$19,054.61	$36,307.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,041.74 / $2,754.23	Professional		$1,479.11	$2,041.74	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $25,703.96 / $50,118.72	Facility		$3,467.37	$25,703.96	$50,118.72
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $2,951.21	Professional		$1,096.48	$1,621.81	$2,951.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,122.02 / $1,862.09	Professional		$977.24	$1,122.02	$1,862.09