Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $6,025.60 / $18,620.87	Facility		$831.76	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $562.34 / $1,348.96	Professional		$416.87	$562.34	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $2,454.71	Facility		$645.65	$645.65	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $691.83 / $1,348.96	Professional		$436.52	$691.83	$1,348.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,096.48 / $5,754.40	Facility		$549.54	$1,096.48	$5,754.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,047.13 / $1,949.84	Professional		$549.54	$1,047.13	$1,949.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $281.84	Professional		$32.36	$33.11	$281.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $831.76 / $870.96	Facility		$645.65	$831.76	$870.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $602.56 / $724.44	Facility		$575.44	$602.56	$724.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $977.24 / $1,288.25	Professional		$602.56	$977.24	$1,288.25
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 $588.84 / $912.01 / $1,348.96	Professional		$588.84	$912.01	$1,348.96
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 $446.68 / $645.65 / $1,202.26	Professional		$446.68	$645.65	$1,202.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $524.81 / $741.31	Professional		$58.88	$524.81	$741.31