Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $14,791.08 / $25,703.96	Facility		$2,570.40	$14,791.08	$25,703.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,380.38 / $1,513.56	Professional		$1,023.29	$1,380.38	$1,513.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $870.96	Facility		$707.95	$758.58	$870.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $11,220.18 / $18,620.87 / $60,255.96	Facility		$11,220.18	$18,620.87	$60,255.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10,715.19 / $16,982.44 / $24,547.09	Professional		$10,715.19	$16,982.44	$24,547.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $64.57	Professional		$33.11	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,187.76 / $2,754.23	Facility		$1,659.59	$2,187.76	$2,754.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,905.46	Facility		$1,778.28	$1,778.28	$1,905.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,818.38 / $3,981.07	Professional		$1,905.46	$2,818.38	$3,981.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $28,183.83 / $36,307.81 / $70,794.58	Facility		$28,183.83	$36,307.81	$70,794.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,511.89 / $3,388.44	Professional		$1,819.70	$2,511.89	$3,388.44
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $38,018.94 / $72,443.60	Facility		$4,265.80	$38,018.94	$72,443.60
United Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,089.30 / $3,715.35	Professional		$1,380.38	$2,089.30	$3,715.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.02	Professional		$0.02	$0.02	$0.02