Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,698.24 / $7,413.10	Facility		$1,047.13	$1,698.24	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $891.25 / $2,041.74	Professional		$707.95	$891.25	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $2,398.83 / $2,754.23	Facility		$1,096.48	$2,398.83	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,230.27 / $1,513.56	Professional		$549.54	$1,230.27	$1,513.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $3,630.78	Facility		$1,047.13	$1,318.26	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $2,884.03	Professional		$1,047.13	$1,318.26	$2,884.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $75.86	Professional		$64.57	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,995.26	Facility		$1,047.13	$1,047.13	$1,995.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,819.70 / $3,162.28	Facility		$1,047.13	$1,819.70	$3,162.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $1,258.93	Professional		$954.99	$954.99	$1,258.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,584.89 / $2,884.03	Facility		$1,096.48	$1,584.89	$2,884.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $954.99 / $1,148.15	Professional		$891.25	$954.99	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,258.93 / $1,258.93	Facility		$1,047.13	$1,258.93	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $1,174.90	Professional		$436.52	$436.52	$1,174.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $1,905.46	Professional		$467.74	$467.74	$1,905.46