Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $8,709.64 / $19,498.45	Facility		$1,819.70	$8,709.64	$19,498.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,548.82 / $2,344.23	Professional		$1,174.90	$1,548.82	$2,344.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,981.07 / $5,011.87	Facility		$2,041.74	$3,981.07	$5,011.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,949.84 / $8,912.51	Facility		$1,737.80	$1,949.84	$8,912.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,949.84 / $3,467.37	Professional		$1,737.80	$1,949.84	$3,467.37
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 $1,949.84 / $1,949.84 / $2,691.53	Facility		$1,949.84	$1,949.84	$2,691.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $3,388.44 / $5,888.44	Facility		$1,949.84	$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 / $2,884.03 / $5,370.32	Facility		$2,041.74	$2,884.03	$5,370.32
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 $812.83 / $812.83 / $2,187.76	Professional		$812.83	$812.83	$2,187.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,949.84 / $3,467.37	Professional		$870.96	$1,949.84	$3,467.37