Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,290.87 / $2,818.38	Professional		$1,698.24	$2,290.87	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $3,019.95 / $14,125.38	Facility		$2,754.23	$3,019.95	$14,125.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,019.95 / $5,128.61	Professional		$2,454.71	$3,019.95	$5,128.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $4,265.80	Facility		$3,019.95	$3,019.95	$4,265.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $3,801.89	Professional		$2,754.23	$2,754.23	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,754.23 / $3,388.44	Professional		$2,570.40	$2,754.23	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $3,630.78	Professional		$1,288.25	$1,288.25	$3,630.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38