Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $7,943.28 / $20,892.96	Facility		$1,659.59	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,047.13 / $2,238.72	Professional		$812.83	$1,047.13	$2,238.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,754.23	Professional		$812.83	$1,380.38	$2,754.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,187.76 / $10,964.78	Facility		$1,071.52	$2,187.76	$10,964.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $2,089.30 / $3,981.07	Professional		$1,071.52	$2,089.30	$3,981.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $512.86	Professional		$32.36	$33.11	$512.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $1,737.80	Facility		$1,202.26	$1,659.59	$1,737.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,202.26	Facility		$1,148.15	$1,148.15	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,949.84 / $2,511.89	Professional		$1,202.26	$1,949.84	$2,511.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $11,481.54 / $21,877.62	Facility		$8,317.64	$11,481.54	$21,877.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,778.28 / $2,754.23	Professional		$1,174.90	$1,778.28	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $11,748.98 / $23,442.29	Facility		$1,380.38	$11,748.98	$23,442.29
United Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,288.25 / $2,398.83	Professional		$870.96	$1,288.25	$2,398.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $1,047.13 / $1,479.11	Professional		$114.82	$1,047.13	$1,479.11