Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $7,762.47 / $20,892.96	Facility		$1,737.80	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,096.48 / $2,454.71	Professional		$691.83	$1,096.48	$2,454.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $2,454.71	Facility		$741.31	$741.31	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,380.38 / $2,818.38	Professional		$831.76	$1,380.38	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,318.26 / $5,754.40	Facility		$977.24	$1,318.26	$5,754.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,318.26 / $2,454.71	Professional		$977.24	$1,318.26	$2,454.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $524.81	Professional		$32.36	$33.11	$524.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,584.89 / $1,819.70	Facility		$1,096.48	$1,584.89	$1,819.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,202.26 / $1,230.27	Facility		$933.25	$1,202.26	$1,230.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,041.74 / $2,570.40	Professional		$1,230.27	$2,041.74	$2,570.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $6,606.93 / $12,589.25	Facility		$4,365.16	$6,606.93	$12,589.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,778.28 / $2,754.23	Professional		$1,230.27	$1,778.28	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $7,413.10 / $13,489.63	Facility		$1,380.38	$7,413.10	$13,489.63
United Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,230.27 / $2,344.23	Professional		$831.76	$1,230.27	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $1,096.48 / $1,548.82	Professional		$117.49	$1,096.48	$1,548.82