Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $7,762.47 / $20,892.96	Facility		$1,778.28	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,122.02 / $2,570.40	Professional		$707.95	$1,122.02	$2,570.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,445.44 / $2,951.21	Professional		$831.76	$1,445.44	$2,951.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,949.84 / $9,549.93	Facility		$1,000.00	$1,949.84	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,949.84 / $3,090.30	Professional		$1,000.00	$1,949.84	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $537.03	Professional		$32.36	$33.11	$537.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,621.81 / $1,862.09	Facility		$1,122.02	$1,621.81	$1,862.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,445.44	Facility		$1,258.93	$1,258.93	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,089.30 / $2,691.53	Professional		$1,258.93	$2,089.30	$2,691.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $10,964.78 / $20,892.96	Facility		$7,943.28	$10,964.78	$20,892.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,905.46 / $2,818.38	Professional		$1,258.93	$1,905.46	$2,818.38
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 $851.14 / $1,258.93 / $2,398.83	Professional		$851.14	$1,258.93	$2,398.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $1,148.15 / $1,621.81	Professional		$123.03	$1,148.15	$1,621.81