Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $6,918.31 / $15,488.17	Facility		$1,445.44	$6,918.31	$15,488.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $1,862.09	Professional		$912.01	$1,230.27	$1,862.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,388.44 / $3,981.07	Facility		$1,584.89	$3,388.44	$3,981.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,548.82 / $7,079.46	Facility		$1,380.38	$1,548.82	$7,079.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,548.82 / $2,630.27	Professional		$1,230.27	$1,548.82	$2,630.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $2,137.96	Facility		$1,548.82	$1,548.82	$2,137.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,691.53 / $4,570.88	Facility		$1,548.82	$2,691.53	$4,570.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,862.09	Professional		$1,380.38	$1,380.38	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,290.87 / $4,265.80	Facility		$1,621.81	$2,290.87	$4,265.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,380.38 / $1,737.80	Professional		$1,318.26	$1,380.38	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,862.09 / $1,862.09	Facility		$1,548.82	$1,862.09	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $1,737.80	Professional		$645.65	$645.65	$1,737.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,548.82 / $2,754.23	Professional		$691.83	$1,548.82	$2,754.23