Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $16,595.87 / $36,307.81	Facility		$3,467.37	$16,595.87	$36,307.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,884.03 / $3,548.13	Professional		$2,398.83	$2,884.03	$3,548.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $8,128.31 / $9,549.93	Facility		$3,801.89	$8,128.31	$9,549.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $16,982.44	Facility		$3,715.35	$3,715.35	$16,982.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,715.35 / $6,309.57	Professional		$2,951.21	$3,715.35	$6,309.57
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 $3,715.35 / $3,715.35 / $5,128.61	Facility		$3,715.35	$3,715.35	$5,128.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $6,456.54 / $10,964.78	Facility		$3,715.35	$6,456.54	$10,964.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $4,365.16	Professional		$3,311.31	$3,311.31	$4,365.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $5,495.41 / $10,000.00	Facility		$3,890.45	$5,495.41	$10,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,311.31 / $4,073.80	Professional		$3,090.30	$3,311.31	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,365.16 / $4,365.16	Facility		$3,715.35	$4,365.16	$4,365.16
United Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $4,073.80	Professional		$1,548.82	$1,548.82	$4,073.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $3,715.35 / $6,606.93	Professional		$1,659.59	$3,715.35	$6,606.93