Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $5,888.44 / $12,882.50	Facility		$1,047.13	$5,888.44	$12,882.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,047.13 / $1,548.82	Professional		$776.25	$1,047.13	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,884.03 / $3,388.44	Facility		$1,348.96	$2,884.03	$3,388.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,318.26 / $6,025.60	Facility		$1,174.90	$1,318.26	$6,025.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $2,238.72	Professional		$1,047.13	$1,318.26	$2,238.72
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 $1,174.90 / $1,445.44 / $2,290.87	Facility		$1,174.90	$1,445.44	$2,290.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,290.87 / $3,890.45	Facility		$1,318.26	$2,290.87	$3,890.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,548.82	Professional		$1,174.90	$1,174.90	$1,548.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,949.84 / $3,548.13	Facility		$1,380.38	$1,949.84	$3,548.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,174.90 / $1,445.44	Professional		$1,096.48	$1,174.90	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,548.82 / $1,548.82	Facility		$1,318.26	$1,548.82	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $549.54 / $1,445.44	Professional		$467.74	$549.54	$1,445.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,318.26 / $2,344.23	Professional		$588.84	$1,318.26	$2,344.23