Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $7,943.28 / $20,892.96	Facility		$2,187.76	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,288.25 / $3,388.44	Professional		$1,047.13	$1,288.25	$3,388.44
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 $1,380.38 / $2,187.76 / $3,548.13	Professional		$1,380.38	$2,187.76	$3,548.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,818.38 / $15,848.93	Facility		$1,584.89	$2,818.38	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,570.40 / $5,495.41	Professional		$1,513.56	$2,570.40	$5,495.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,238.72 / $2,344.23	Facility		$1,737.80	$2,238.72	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,691.53 / $3,388.44	Professional		$1,584.89	$2,691.53	$3,388.44
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 $1,584.89 / $2,238.72 / $3,019.95	Professional		$1,584.89	$2,238.72	$3,019.95
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 $1,148.15 / $1,819.70 / $3,311.31	Professional		$1,148.15	$1,819.70	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,380.38 / $1,949.84	Professional		$1,023.29	$1,380.38	$1,949.84