Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $7,762.47 / $20,892.96	Facility		$933.25	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $616.60 / $1,348.96	Professional		$457.09	$616.60	$1,348.96
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 $489.78 / $776.25 / $1,513.56	Professional		$489.78	$776.25	$1,513.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,258.93 / $9,549.93	Facility		$602.56	$1,258.93	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,174.90 / $3,090.30	Professional		$602.56	$1,174.90	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $933.25 / $977.24	Facility		$707.95	$933.25	$977.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $660.69 / $933.25	Facility		$645.65	$660.69	$933.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,096.48 / $1,412.54	Professional		$660.69	$1,096.48	$1,412.54
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 $660.69 / $1,000.00 / $1,548.82	Professional		$660.69	$1,000.00	$1,548.82
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 $501.19 / $724.44 / $1,348.96	Professional		$501.19	$724.44	$1,348.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $575.44 / $812.83	Professional		$64.57	$575.44	$812.83