Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $7,762.47 / $20,892.96	Facility		$1,905.46	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,288.25 / $2,884.03	Professional		$851.14	$1,288.25	$2,884.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,621.81 / $3,311.31	Professional		$954.99	$1,621.81	$3,311.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,089.30 / $9,549.93	Facility		$1,202.26	$2,089.30	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $3,162.28	Professional		$1,202.26	$2,041.74	$3,162.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $616.60	Professional		$32.36	$33.11	$616.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,905.46 / $2,089.30	Facility		$1,380.38	$1,905.46	$2,089.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,445.44	Facility		$1,412.54	$1,412.54	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,398.83 / $3,019.95	Professional		$1,445.44	$2,398.83	$3,019.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $10,964.78 / $20,892.96	Facility		$7,244.36	$10,964.78	$20,892.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,089.30 / $3,162.28	Professional		$1,445.44	$2,089.30	$3,162.28
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 $1,023.29 / $1,479.11 / $2,818.38	Professional		$1,023.29	$1,479.11	$2,818.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $1,258.93 / $1,778.28	Professional		$138.04	$1,258.93	$1,778.28