Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $8,912.51 / $20,892.96	Facility		$1,905.46	$8,912.51	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,288.25 / $3,981.07	Professional		$758.58	$1,288.25	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $2,454.71	Facility		$1,023.29	$1,023.29	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,548.82 / $3,090.30	Professional		$912.01	$1,548.82	$3,090.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $5,754.40	Facility		$1,047.13	$1,318.26	$5,754.40
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,754.40 / $9,332.54 / $16,595.87	Facility	50	$5,754.40	$9,332.54	$16,595.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $2,570.40	Professional		$1,047.13	$1,318.26	$2,570.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $575.44	Professional		$32.36	$33.11	$575.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $1,995.26	Facility		$1,258.93	$1,737.80	$1,995.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,348.96 / $1,348.96	Facility		$933.25	$1,348.96	$1,348.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,238.72 / $2,818.38	Professional		$1,348.96	$2,238.72	$2,818.38
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 Facility Modifier 50 Low / Median / High Price $6,606.93 / $10,000.00 / $19,054.61	Facility	50	$6,606.93	$10,000.00	$19,054.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,949.84 / $3,019.95	Professional		$1,348.96	$1,949.84	$3,019.95
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 $912.01 / $1,348.96 / $2,570.40	Professional		$912.01	$1,348.96	$2,570.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $1,202.26 / $1,698.24	Professional		$128.82	$1,202.26	$1,698.24