Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $7,943.28 / $24,547.09	Facility		$2,398.83	$7,943.28	$24,547.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,380.38 / $3,630.78	Professional		$1,122.02	$1,380.38	$3,630.78
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 $1,445.44 / $2,398.83 / $3,890.45	Professional		$1,445.44	$2,398.83	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,090.30 / $15,848.93	Facility		$1,659.59	$3,090.30	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $5,495.41	Professional		$1,659.59	$2,754.23	$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 $1,778.28 / $2,344.23 / $2,511.89	Facility		$1,778.28	$2,344.23	$2,511.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,737.80 / $1,737.80	Facility		$1,698.24	$1,737.80	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,884.03 / $3,630.78	Professional		$1,737.80	$2,884.03	$3,630.78
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 $1,737.80 / $2,454.71 / $3,235.94	Professional		$1,737.80	$2,454.71	$3,235.94
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 $1,202.26 / $1,905.46 / $3,548.13	Professional		$1,202.26	$1,905.46	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,584.89 / $2,238.72	Professional		$1,174.90	$1,584.89	$2,238.72