Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $7,943.28 / $20,892.96	Facility		$1,412.54	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $954.99 / $2,041.74	Professional		$630.96	$954.99	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $5,011.87	Facility		$1,023.29	$1,023.29	$5,011.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,288.25 / $2,137.96	Professional		$691.83	$1,288.25	$2,137.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,238.72 / $10,964.78	Facility		$1,202.26	$2,238.72	$10,964.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,737.80 / $3,981.07	Professional		$1,202.26	$1,737.80	$3,981.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,230.27 / $1,819.70	Facility		$1,023.29	$1,230.27	$1,819.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,000.00 / $1,862.09	Facility		$851.14	$1,000.00	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,412.54 / $1,862.09	Professional		$851.14	$1,412.54	$1,862.09
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 $1,023.29 / $1,318.26 / $2,754.23	Professional		$1,023.29	$1,318.26	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $12,882.50 / $23,442.29	Facility		$2,398.83	$12,882.50	$23,442.29
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,412.54 / $2,238.72	Professional		$812.83	$1,412.54	$2,238.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $741.31 / $1,047.13	Professional		$83.18	$741.31	$1,047.13