Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,128.61 / $24,547.09 / $54,954.09	Facility		$5,128.61	$24,547.09	$54,954.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $6,918.31	Professional		$3,311.31	$4,365.16	$6,918.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $12,022.64 / $14,125.38	Facility		$5,754.40	$12,022.64	$14,125.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $5,495.41 / $25,118.86	Facility		$4,897.79	$5,495.41	$25,118.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $5,495.41 / $9,332.54	Professional		$4,365.16	$5,495.41	$9,332.54
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 $5,495.41 / $5,495.41 / $7,585.78	Facility		$5,495.41	$5,495.41	$7,585.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $9,549.93 / $16,595.87	Facility		$5,495.41	$9,549.93	$16,595.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $6,606.93	Professional		$4,897.79	$4,897.79	$6,606.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $8,128.31 / $15,135.61	Facility		$5,754.40	$8,128.31	$15,135.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,677.35 / $4,897.79 / $6,165.95	Professional		$4,677.35	$4,897.79	$6,165.95
United Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $6,606.93 / $6,606.93	Facility		$5,495.41	$6,606.93	$6,606.93
United Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $6,165.95	Professional		$2,290.87	$2,290.87	$6,165.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $5,495.41 / $9,772.37	Professional		$2,454.71	$5,495.41	$9,772.37