Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $6,456.54 / $20,892.96	Facility		$1,584.89	$6,456.54	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $977.24 / $1,995.26	Professional		$660.69	$977.24	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $2,884.03	Facility		$912.01	$912.01	$2,884.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,288.25 / $2,630.27	Professional		$776.25	$1,288.25	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,513.56 / $5,888.44	Facility		$933.25	$1,513.56	$5,888.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,513.56 / $2,398.83	Professional		$933.25	$1,513.56	$2,398.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $489.78	Professional		$32.36	$33.11	$489.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $1,659.59	Facility		$1,047.13	$1,513.56	$1,659.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,862.09 / $2,398.83	Professional		$1,122.02	$1,862.09	$2,398.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $6,606.93 / $12,589.25	Facility		$4,786.30	$6,606.93	$12,589.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,659.59 / $2,511.89	Professional		$1,122.02	$1,659.59	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $7,244.36 / $13,182.57	Facility		$1,380.38	$7,244.36	$13,182.57
United Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,174.90 / $2,238.72	Professional		$794.33	$1,174.90	$2,238.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $1,023.29 / $1,412.54	Professional		$109.65	$1,023.29	$1,412.54