Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $7,943.28 / $24,547.09	Facility		$2,951.21	$7,943.28	$24,547.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,737.80 / $4,168.69	Professional		$1,412.54	$1,737.80	$4,168.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $6,918.31	Facility		$4,168.69	$4,168.69	$6,918.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,951.21 / $4,786.30	Professional		$1,778.28	$2,951.21	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $3,715.35 / $15,848.93	Facility		$2,089.30	$3,715.35	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,467.37 / $5,495.41	Professional		$2,041.74	$3,467.37	$5,495.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,884.03 / $3,162.28	Facility		$2,238.72	$2,884.03	$3,162.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,137.96	Facility		$2,137.96	$2,137.96	$2,137.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,630.78 / $4,570.88	Professional		$2,137.96	$3,630.78	$4,570.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $16,595.87 / $31,622.78	Facility		$10,964.78	$16,595.87	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,019.95 / $4,073.80	Professional		$2,187.76	$3,019.95	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $20,417.38 / $35,481.34	Facility		$3,467.37	$20,417.38	$35,481.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,344.23 / $4,365.16	Professional		$1,479.11	$2,344.23	$4,365.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,949.84 / $2,754.23	Professional		$1,445.44	$1,949.84	$2,754.23