Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $13,803.84 / $30,199.52	Facility		$2,818.38	$13,803.84	$30,199.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,398.83 / $3,090.30	Professional		$1,819.70	$2,398.83	$3,090.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $6,760.83 / $7,762.47	Facility		$3,162.28	$6,760.83	$7,762.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $3,019.95 / $14,125.38	Facility		$2,754.23	$3,019.95	$14,125.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,019.95 / $5,128.61	Professional		$2,398.83	$3,019.95	$5,128.61
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 $3,019.95 / $3,019.95 / $4,265.80	Facility		$3,019.95	$3,019.95	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $5,248.07 / $9,120.11	Facility		$3,019.95	$5,248.07	$9,120.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $3,630.78	Professional		$2,754.23	$2,754.23	$3,630.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $4,570.88 / $7,943.28	Facility		$3,162.28	$4,570.88	$7,943.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,754.23 / $3,388.44	Professional		$2,570.40	$2,754.23	$3,388.44
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,630.78 / $3,630.78	Facility		$3,019.95	$3,630.78	$3,630.78
United Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $3,388.44	Professional		$1,258.93	$1,258.93	$3,388.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $3,019.95 / $5,495.41	Professional		$1,348.96	$3,019.95	$5,495.41