Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $11,748.98 / $21,877.62	Facility		$2,187.76	$11,748.98	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $2,187.76 / $7,585.78	Professional		$1,000.00	$2,187.76	$7,585.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $10,232.93 / $48,977.88 / $83,176.38	Facility		$10,232.93	$48,977.88	$83,176.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $17,378.01 / $17,378.01 / $17,378.01	Professional		$17,378.01	$17,378.01	$17,378.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $64.57	Professional		$32.36	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $5,754.40 / $7,079.46	Facility		$4,073.80	$5,754.40	$7,079.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Facility		$3,162.28	$3,162.28	$3,162.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $5,248.07 / $15,135.61	Professional		$3,162.28	$5,248.07	$15,135.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $22,387.21 / $30,902.95 / $60,255.96	Facility		$22,387.21	$30,902.95	$60,255.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $6,606.93 / $13,803.84	Professional		$3,235.94	$6,606.93	$13,803.84
United Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $40,738.03 / $69,183.10	Facility		$8,511.38	$40,738.03	$69,183.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,137.96 / $6,760.83	Professional		$1,288.25	$2,137.96	$6,760.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.02	Professional		$0.02	$0.02	$0.02