Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $7,762.47 / $20,892.96	Facility		$1,318.26	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $776.25 / $1,995.26	Professional		$616.60	$776.25	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility		$3,311.31	$3,311.31	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,318.26 / $2,137.96	Professional		$812.83	$1,318.26	$2,137.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,659.59 / $8,317.64	Facility		$912.01	$1,659.59	$8,317.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,548.82 / $2,691.53	Professional		$912.01	$1,548.82	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,318.26 / $1,412.54	Facility		$1,000.00	$1,318.26	$1,412.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $954.99 / $954.99	Facility		$933.25	$954.99	$954.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,584.89 / $1,995.26	Professional		$954.99	$1,584.89	$1,995.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $9,332.54 / $17,378.01	Facility		$6,918.31	$9,332.54	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,348.96 / $1,778.28	Professional		$954.99	$1,348.96	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,481.54 / $19,952.62	Facility		$1,995.26	$11,481.54	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,071.52 / $1,949.84	Professional		$660.69	$1,071.52	$1,949.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $1,202.26	Professional		$630.96	$851.14	$1,202.26