Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $11,481.54 / $25,703.96	Facility		$2,398.83	$11,481.54	$25,703.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,089.30 / $2,511.89	Professional		$1,548.82	$2,089.30	$2,511.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $5,754.40 / $6,606.93	Facility		$2,691.53	$5,754.40	$6,606.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,570.40 / $12,022.64	Facility		$2,290.87	$2,570.40	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,570.40 / $4,365.16	Professional		$2,041.74	$2,570.40	$4,365.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $3,630.78	Facility		$2,570.40	$2,570.40	$3,630.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,466.84 / $7,762.47	Facility		$2,570.40	$4,466.84	$7,762.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $3,090.30	Professional		$2,290.87	$2,290.87	$3,090.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,890.45 / $7,079.46	Facility		$2,691.53	$3,890.45	$7,079.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,290.87 / $2,884.03	Professional		$2,187.76	$2,290.87	$2,884.03
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,090.30 / $3,090.30	Facility		$2,570.40	$3,090.30	$3,090.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $2,884.03	Professional		$1,071.52	$1,071.52	$2,884.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $2,570.40 / $4,677.35	Professional		$1,148.15	$2,570.40	$4,677.35