Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $9,772.37 / $18,620.87	Facility		$1,737.80	$9,772.37	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,513.56 / $2,238.72	Professional		$1,122.02	$1,513.56	$2,238.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $4,168.69 / $4,786.30	Facility		$1,949.84	$4,168.69	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,862.09 / $2,951.21	Facility		$1,479.11	$1,862.09	$2,951.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,862.09 / $3,162.28	Professional		$1,479.11	$1,862.09	$3,162.28
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 $1,862.09 / $1,862.09 / $2,630.27	Facility		$1,862.09	$1,862.09	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,235.94 / $5,623.41	Facility		$1,862.09	$3,235.94	$5,623.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $2,238.72	Professional		$1,659.59	$1,659.59	$2,238.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,818.38 / $5,128.61	Facility		$1,949.84	$2,818.38	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,659.59 / $2,089.30	Professional		$1,584.89	$1,659.59	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $2,089.30	Professional		$776.25	$776.25	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,862.09 / $3,388.44	Professional		$831.76	$1,862.09	$3,388.44