Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $12,302.69 / $26,915.35	Facility		$2,570.40	$12,302.69	$26,915.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,187.76 / $3,235.94	Professional		$1,621.81	$2,187.76	$3,235.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $6,025.60 / $6,918.31	Facility		$2,818.38	$6,025.60	$6,918.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,691.53 / $12,589.25	Facility		$2,454.71	$2,691.53	$12,589.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,691.53 / $4,570.88	Professional		$2,187.76	$2,691.53	$4,570.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $3,801.89	Facility		$2,691.53	$2,691.53	$3,801.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $4,786.30 / $8,128.31	Facility		$2,691.53	$4,786.30	$8,128.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $3,235.94	Professional		$2,454.71	$2,454.71	$3,235.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,073.80 / $7,413.10	Facility		$2,818.38	$4,073.80	$7,413.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,454.71 / $3,019.95	Professional		$2,290.87	$2,454.71	$3,019.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,235.94 / $3,235.94	Facility		$2,691.53	$3,235.94	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $3,019.95	Professional		$1,148.15	$1,148.15	$3,019.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,691.53 / $4,897.79	Professional		$1,230.27	$2,691.53	$4,897.79