Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,819.70 / $2,344.23	Professional		$1,412.54	$1,819.70	$2,344.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,511.89 / $3,981.07	Facility		$1,995.26	$2,511.89	$3,981.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,511.89 / $4,265.80	Professional		$1,995.26	$2,511.89	$4,265.80
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 $2,511.89 / $2,511.89 / $3,548.13	Facility		$2,511.89	$2,511.89	$3,548.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $4,466.84 / $6,165.95	Professional		$3,090.30	$4,466.84	$6,165.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,238.72 / $2,818.38	Professional		$2,137.96	$2,238.72	$2,818.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $5,495.41	Professional		$1,047.13	$1,513.56	$5,495.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02