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 $691.83 / $933.25 / $1,995.26	Professional		$691.83	$933.25	$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 $691.83 / $1,174.90 / $2,290.87	Professional		$691.83	$1,174.90	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,513.56 / $5,888.44	Facility		$912.01	$1,513.56	$5,888.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,479.11 / $2,290.87	Professional		$912.01	$1,479.11	$2,290.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $436.52	Professional		$32.36	$33.11	$436.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $1,479.11	Facility		$1,071.52	$1,445.44	$1,479.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,023.29 / $1,122.02	Facility		$977.24	$1,023.29	$1,122.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,659.59 / $2,137.96	Professional		$1,023.29	$1,659.59	$2,137.96
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 $1,000.00 / $1,513.56 / $2,290.87	Professional		$1,000.00	$1,513.56	$2,290.87
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 $758.58 / $1,096.48 / $2,041.74	Professional		$758.58	$1,096.48	$2,041.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $870.96 / $1,230.27	Professional		$97.72	$870.96	$1,230.27