Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $7,943.28 / $19,498.45	Facility		$1,659.59	$7,943.28	$19,498.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,479.11 / $1,698.24	Professional		$1,047.13	$1,479.11	$1,698.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $4,365.16 / $5,011.87	Facility		$2,041.74	$4,365.16	$5,011.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,949.84 / $8,128.31	Facility		$1,737.80	$1,949.84	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,949.84 / $3,311.31	Professional		$1,548.82	$1,949.84	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,754.23	Facility		$1,949.84	$1,949.84	$2,754.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,388.44 / $5,888.44	Facility		$2,187.76	$3,388.44	$5,888.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $2,344.23	Professional		$1,737.80	$1,737.80	$2,344.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,951.21 / $5,128.61	Facility		$2,041.74	$2,951.21	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,737.80 / $2,187.76	Professional		$1,659.59	$1,737.80	$2,187.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,344.23 / $2,344.23	Facility		$1,949.84	$2,344.23	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,949.84	Professional		$741.31	$741.31	$1,949.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,949.84 / $3,548.13	Professional		$870.96	$1,949.84	$3,548.13