Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $7,762.47 / $20,892.96	Facility		$2,187.76	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,445.44 / $3,090.30	Professional		$977.24	$1,445.44	$3,090.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $3,801.89	Facility		$741.31	$741.31	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,905.46 / $3,801.89	Professional		$1,122.02	$1,905.46	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,089.30 / $9,549.93	Facility		$1,412.54	$2,089.30	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,089.30 / $3,467.37	Professional		$1,412.54	$2,089.30	$3,467.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $707.95	Professional		$32.36	$33.11	$707.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,238.72 / $2,454.71	Facility		$1,584.89	$2,238.72	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,621.81 / $1,659.59	Facility		$1,445.44	$1,621.81	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $3,548.13	Professional		$1,659.59	$2,754.23	$3,548.13
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 $1,659.59 / $2,398.83 / $3,715.35	Professional		$1,659.59	$2,398.83	$3,715.35
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 $1,174.90 / $1,698.24 / $3,311.31	Professional		$1,174.90	$1,698.24	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $1,445.44 / $2,041.74	Professional		$162.18	$1,445.44	$2,041.74