Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $7,762.47 / $20,892.96	Facility		$1,621.81	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,047.13 / $2,344.23	Professional		$645.65	$1,047.13	$2,344.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $3,801.89	Facility		$741.31	$741.31	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,318.26 / $2,691.53	Professional		$776.25	$1,318.26	$2,691.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,949.84 / $9,549.93	Facility		$912.01	$1,949.84	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,819.70 / $3,090.30	Professional		$912.01	$1,819.70	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $501.19	Professional		$32.36	$33.11	$501.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,479.11 / $1,698.24	Facility		$1,023.29	$1,479.11	$1,698.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,174.90	Facility		$1,148.15	$1,148.15	$1,174.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,949.84 / $2,454.71	Professional		$1,174.90	$1,949.84	$2,454.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $10,964.78 / $20,892.96	Facility		$7,244.36	$10,964.78	$20,892.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,737.80 / $2,570.40	Professional		$1,174.90	$1,737.80	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $12,022.64 / $22,387.21	Facility		$1,698.24	$12,022.64	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,174.90 / $2,238.72	Professional		$758.58	$1,174.90	$2,238.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $1,047.13 / $1,479.11	Professional		$112.20	$1,047.13	$1,479.11