Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,548.13 / $18,620.87	Facility		$2,290.87	$3,548.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,479.11 / $3,388.44	Professional		$1,148.15	$1,479.11	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $8,709.64	Facility		$467.74	$562.34	$8,709.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $2,089.30 / $3,890.45	Professional		$1,174.90	$2,089.30	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,630.27 / $9,332.54	Facility		$1,318.26	$2,630.27	$9,332.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,511.89 / $7,244.36	Professional		$1,318.26	$2,511.89	$7,244.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,511.89 / $2,630.27	Facility		$1,949.84	$2,511.89	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,778.28 / $1,819.70	Facility		$1,737.80	$1,778.28	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,754.23 / $3,715.35	Professional		$1,778.28	$2,754.23	$3,715.35
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 $1,778.28 / $2,454.71 / $3,311.31	Professional		$1,778.28	$2,454.71	$3,311.31
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 $1,258.93 / $1,949.84 / $3,548.13	Professional		$1,258.93	$1,949.84	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,348.96 / $2,187.76	Professional		$1,174.90	$1,348.96	$2,187.76