Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $10,000.00 / $21,877.62	Facility		$2,089.30	$10,000.00	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,778.28 / $2,137.96	Professional		$1,318.26	$1,778.28	$2,137.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $4,897.79 / $5,623.41	Facility		$2,290.87	$4,897.79	$5,623.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,187.76 / $10,232.93	Facility		$1,995.26	$2,187.76	$10,232.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,187.76 / $3,715.35	Professional		$1,778.28	$2,187.76	$3,715.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $3,090.30	Facility		$2,187.76	$2,187.76	$3,090.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,890.45 / $6,606.93	Facility		$2,187.76	$3,890.45	$6,606.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,630.27	Professional		$1,995.26	$1,995.26	$2,630.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,311.31 / $6,025.60	Facility		$2,290.87	$3,311.31	$6,025.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,995.26 / $2,454.71	Professional		$1,862.09	$1,995.26	$2,454.71
United Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,630.27 / $2,630.27	Facility		$2,187.76	$2,630.27	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $2,454.71	Professional		$933.25	$933.25	$2,454.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $2,187.76 / $3,981.07	Professional		$1,000.00	$2,187.76	$3,981.07