Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $8,912.51 / $20,892.96	Facility		$2,630.27	$8,912.51	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,659.59 / $4,073.80	Professional		$1,071.52	$1,659.59	$4,073.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $3,801.89	Facility		$1,023.29	$1,023.29	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,137.96 / $4,365.16	Professional		$1,288.25	$2,137.96	$4,365.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,089.30 / $9,549.93	Facility		$1,513.56	$2,089.30	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,089.30 / $3,801.89	Professional		$1,513.56	$2,089.30	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $812.83	Professional		$32.36	$33.11	$812.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,511.89 / $2,754.23	Facility		$1,737.80	$2,511.89	$2,754.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,862.09 / $1,905.46	Facility		$1,513.56	$1,862.09	$1,905.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $3,162.28 / $3,981.07	Professional		$1,905.46	$3,162.28	$3,981.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $10,964.78 / $20,892.96	Facility		$7,943.28	$10,964.78	$20,892.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,754.23 / $4,168.69	Professional		$1,905.46	$2,754.23	$4,168.69
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $12,022.64 / $22,387.21	Facility		$1,698.24	$12,022.64	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,949.84 / $3,715.35	Professional		$1,318.26	$1,949.84	$3,715.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $1,698.24 / $2,344.23	Professional		$181.97	$1,698.24	$2,344.23