Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $14,454.40 / $32,359.37	Facility		$3,019.95	$14,454.40	$32,359.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,630.27 / $3,890.45	Professional		$2,137.96	$2,630.27	$3,890.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $7,244.36 / $8,317.64	Facility		$3,388.44	$7,244.36	$8,317.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,235.94 / $15,135.61	Facility		$3,235.94	$3,235.94	$15,135.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,235.94 / $5,495.41	Professional		$2,570.40	$3,235.94	$5,495.41
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 $2,884.03 / $3,548.13 / $5,623.41	Facility		$2,884.03	$3,548.13	$5,623.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $5,623.41 / $9,772.37	Facility		$3,235.94	$5,623.41	$9,772.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $3,890.45	Professional		$2,884.03	$2,884.03	$3,890.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $4,897.79 / $8,912.51	Facility		$3,388.44	$4,897.79	$8,912.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $2,884.03 / $3,630.78	Professional		$2,754.23	$2,884.03	$3,630.78
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,890.45 / $3,890.45	Facility		$3,235.94	$3,890.45	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $3,630.78	Professional		$1,348.96	$1,348.96	$3,630.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $3,235.94 / $5,888.44	Professional		$1,445.44	$3,235.94	$5,888.44