Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $14,454.40 / $31,622.78	Facility		$3,019.95	$14,454.40	$31,622.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,570.40 / $3,981.07	Professional		$1,905.46	$2,570.40	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $7,079.46 / $8,317.64	Facility		$3,311.31	$7,079.46	$8,317.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,235.94 / $14,791.08	Facility		$2,884.03	$3,235.94	$14,791.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,235.94 / $5,495.41	Professional		$2,570.40	$3,235.94	$5,495.41
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 $3,235.94 / $3,235.94 / $4,466.84	Facility		$3,235.94	$3,235.94	$4,466.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $5,623.41 / $9,549.93	Facility		$3,235.94	$5,623.41	$9,549.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $3,801.89	Professional		$2,884.03	$2,884.03	$3,801.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $4,786.30 / $8,709.64	Facility		$3,388.44	$4,786.30	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,884.03 / $3,548.13	Professional		$2,691.53	$2,884.03	$3,548.13
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,801.89 / $3,801.89	Facility		$3,235.94	$3,801.89	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $3,548.13	Professional		$1,348.96	$1,348.96	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $3,235.94 / $5,754.40	Professional		$1,445.44	$3,235.94	$5,754.40