Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $22,387.21 / $50,118.72	Facility		$4,677.35	$22,387.21	$50,118.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $5,011.87	Professional		$3,311.31	$4,365.16	$5,011.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $10,964.78 / $12,882.50	Facility		$5,248.07	$10,964.78	$12,882.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $5,011.87 / $23,442.29	Facility		$4,466.84	$5,011.87	$23,442.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $5,011.87 / $8,511.38	Professional		$3,981.07	$5,011.87	$8,511.38
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 $5,011.87 / $5,011.87 / $7,079.46	Facility		$5,011.87	$5,011.87	$7,079.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,709.64 / $15,135.61	Facility		$5,011.87	$8,709.64	$15,135.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $6,025.60	Professional		$4,466.84	$4,466.84	$6,025.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $7,585.78 / $13,182.57	Facility		$5,248.07	$7,585.78	$13,182.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,466.84 / $5,623.41	Professional		$4,265.80	$4,466.84	$5,623.41
United Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $6,025.60 / $6,025.60	Facility		$5,011.87	$6,025.60	$6,025.60
United Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $5,623.41	Professional		$2,089.30	$2,089.30	$5,623.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $5,011.87 / $8,912.51	Professional		$2,238.72	$5,011.87	$8,912.51