Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $13,489.63 / $30,199.52	Facility		$2,818.38	$13,489.63	$30,199.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,511.89 / $2,818.38	Professional		$1,513.56	$2,511.89	$2,818.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $6,165.95 / $7,762.47	Facility		$1,862.09	$6,165.95	$7,762.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $13,803.84	Facility		$3,019.95	$3,019.95	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,019.95 / $5,128.61	Professional		$2,691.53	$3,019.95	$5,128.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,311.31 / $5,248.07	Facility		$2,691.53	$3,311.31	$5,248.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $5,248.07 / $8,912.51	Facility		$3,019.95	$5,248.07	$8,912.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $3,630.78	Professional		$2,691.53	$2,691.53	$3,630.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $4,466.84 / $8,317.64	Facility		$3,162.28	$4,466.84	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,691.53 / $3,388.44	Professional		$2,570.40	$2,691.53	$3,388.44
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,630.78 / $3,630.78	Facility		$3,019.95	$3,630.78	$3,630.78
United Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $3,388.44	Professional		$1,258.93	$1,258.93	$3,388.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $3,019.95 / $5,370.32	Professional		$1,348.96	$3,019.95	$5,370.32