Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,819.70 / $2,344.23	Professional		$1,318.26	$1,819.70	$2,344.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $4,897.79 / $22,908.68	Facility		$4,466.84	$4,897.79	$22,908.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $4,897.79 / $8,511.38	Professional		$3,981.07	$4,897.79	$8,511.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $79.43	Professional		$44.67	$50.12	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $5,495.41 / $8,709.64	Facility		$4,466.84	$5,495.41	$8,709.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $4,466.84 / $6,165.95	Professional		$3,090.30	$4,466.84	$6,165.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $4,466.84 / $5,495.41	Professional		$3,981.07	$4,466.84	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $5,495.41	Professional		$1,047.13	$1,513.56	$5,495.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Professional		$2,238.72	$2,238.72	$2,238.72