Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $11,748.98 / $21,877.62	Facility		$3,388.44	$11,748.98	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,466.84 / $5,370.32	Professional		$3,311.31	$4,466.84	$5,370.32
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 $16,982.44 / $16,982.44 / $16,982.44	Professional		$16,982.44	$16,982.44	$16,982.44
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 $5,011.87 / $7,762.47 / $11,748.98	Facility		$5,011.87	$7,762.47	$11,748.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $7,244.36 / $8,128.31	Facility		$7,244.36	$7,244.36	$8,128.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,128.31 / $12,302.69 / $15,488.17	Professional		$8,128.31	$12,302.69	$15,488.17
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 $7,413.10 / $10,964.78 / $15,488.17	Professional		$7,413.10	$10,964.78	$15,488.17
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 $1,096.48 / $1,819.70 / $5,623.41	Professional		$1,096.48	$1,819.70	$5,623.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $0.02	Professional		$0.02	$0.02	$0.02