Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $12,022.64 / $22,908.68	Facility		$3,090.30	$12,022.64	$22,908.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,737.80 / $2,187.76	Professional		$1,380.38	$1,737.80	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $5,011.87 / $5,888.44	Facility		$2,344.23	$5,011.87	$5,888.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,290.87 / $10,471.29	Facility		$2,041.74	$2,290.87	$10,471.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,290.87 / $3,890.45	Professional		$1,819.70	$2,290.87	$3,890.45
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 $2,290.87 / $2,290.87 / $3,162.28	Facility		$2,290.87	$2,290.87	$3,162.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,981.07 / $6,760.83	Facility		$2,290.87	$3,981.07	$6,760.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,754.23	Professional		$2,041.74	$2,041.74	$2,754.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $3,388.44 / $6,025.60	Facility		$2,398.83	$3,388.44	$6,025.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,041.74 / $2,570.40	Professional		$1,949.84	$2,041.74	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,754.23 / $2,754.23	Facility		$2,290.87	$2,754.23	$2,754.23
United Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $2,570.40	Professional		$954.99	$954.99	$2,570.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $2,290.87 / $4,073.80	Professional		$1,023.29	$2,290.87	$4,073.80