Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $6,918.31 / $15,135.61	Facility		$1,412.54	$6,918.31	$15,135.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,202.26 / $1,819.70	Professional		$912.01	$1,202.26	$1,819.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,388.44 / $3,890.45	Facility		$1,584.89	$3,388.44	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,513.56 / $7,079.46	Facility		$1,380.38	$1,513.56	$7,079.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,513.56 / $2,570.40	Professional		$1,202.26	$1,513.56	$2,570.40
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 $1,513.56 / $1,513.56 / $2,137.96	Facility		$1,513.56	$1,513.56	$2,137.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,630.27 / $4,570.88	Facility		$1,513.56	$2,630.27	$4,570.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,819.70	Professional		$1,380.38	$1,380.38	$1,819.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,290.87 / $4,168.69	Facility		$1,584.89	$2,290.87	$4,168.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,380.38 / $1,698.24	Professional		$1,288.25	$1,380.38	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,819.70 / $1,819.70	Facility		$1,513.56	$1,819.70	$1,819.70
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $1,698.24	Professional		$630.96	$630.96	$1,698.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,513.56 / $2,754.23	Professional		$676.08	$1,513.56	$2,754.23