Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $7,943.28 / $17,378.01	Facility		$1,047.13	$7,943.28	$17,378.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,047.13 / $1,445.44	Professional		$776.25	$1,047.13	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,890.45 / $4,466.84	Facility		$1,819.70	$3,890.45	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,737.80 / $8,128.31	Facility		$1,584.89	$1,737.80	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,737.80 / $2,951.21	Professional		$1,380.38	$1,737.80	$2,951.21
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 $1,584.89 / $1,905.46 / $3,019.95	Facility		$1,584.89	$1,905.46	$3,019.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,019.95 / $5,248.07	Facility		$1,737.80	$3,019.95	$5,248.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $2,089.30	Professional		$1,584.89	$1,584.89	$2,089.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $4,570.88	Facility		$1,819.70	$2,630.27	$4,570.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,584.89 / $1,949.84	Professional		$1,479.11	$1,584.89	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,089.30 / $2,089.30	Facility		$1,737.80	$2,089.30	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $676.08 / $1,737.80	Professional		$467.74	$676.08	$1,737.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,737.80 / $3,162.28	Professional		$776.25	$1,737.80	$3,162.28