Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $7,762.47 / $20,892.96	Facility		$1,584.89	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $912.01 / $2,398.83	Professional		$741.31	$912.01	$2,398.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $3,311.31	Facility		$1,995.26	$1,995.26	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,584.89 / $2,570.40	Professional		$977.24	$1,584.89	$2,570.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,995.26 / $8,511.38	Facility		$1,122.02	$1,995.26	$8,511.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $2,691.53	Professional		$1,096.48	$1,862.09	$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 $1,202.26 / $1,584.89 / $1,698.24	Facility		$1,202.26	$1,584.89	$1,698.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,148.15 / $1,148.15	Facility		$1,122.02	$1,148.15	$1,148.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,905.46 / $2,398.83	Professional		$1,148.15	$1,905.46	$2,398.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,120.11 / $17,378.01	Facility		$5,888.44	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $2,187.76	Professional		$1,148.15	$1,621.81	$2,187.76
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 $812.83 / $1,288.25 / $2,344.23	Professional		$812.83	$1,288.25	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,023.29 / $1,445.44	Professional		$758.58	$1,023.29	$1,445.44