Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $10,232.93 / $28,183.83	Facility		$1,949.84	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,819.70 / $3,162.28	Professional		$1,318.26	$1,819.70	$3,162.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $8,511.38 / $13,182.57	Facility		$2,691.53	$8,511.38	$13,182.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Professional		$3,801.89	$3,801.89	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $64.57	Professional		$44.67	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $2,691.53	Facility		$1,174.90	$1,659.59	$2,691.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,467.37 / $4,786.30	Professional		$2,511.89	$3,467.37	$4,786.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,760.83 / $9,120.11 / $16,982.44	Facility		$6,760.83	$9,120.11	$16,982.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,570.40 / $3,981.07	Professional		$1,819.70	$2,570.40	$3,981.07
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,220.18 / $19,498.45	Facility		$1,995.26	$11,220.18	$19,498.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,951.21 / $5,370.32	Professional		$1,584.89	$2,951.21	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Professional		$1,905.46	$1,905.46	$1,905.46