Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $15,848.93 / $34,673.69	Facility		$1,778.28	$15,848.93	$34,673.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,949.84 / $3,311.31	Professional		$1,778.28	$1,949.84	$3,311.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $7,762.47 / $9,120.11	Facility		$3,630.78	$7,762.47	$9,120.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,467.37 / $16,218.10	Facility		$3,162.28	$3,467.37	$16,218.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $3,467.37 / $5,888.44	Professional		$2,818.38	$3,467.37	$5,888.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $4,897.79	Facility		$3,467.37	$3,467.37	$4,897.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $6,165.95 / $10,471.29	Facility		$3,467.37	$6,165.95	$10,471.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $4,168.69	Professional		$3,162.28	$3,162.28	$4,168.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $5,248.07 / $9,549.93	Facility		$3,715.35	$5,248.07	$9,549.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,162.28 / $3,890.45	Professional		$2,951.21	$3,162.28	$3,890.45
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $4,168.69 / $4,168.69	Facility		$3,467.37	$4,168.69	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $3,890.45	Professional		$1,479.11	$1,479.11	$3,890.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $3,467.37 / $6,309.57	Professional		$1,584.89	$3,467.37	$6,309.57