Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $17,782.79 / $28,183.83	Facility		$2,818.38	$17,782.79	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,000.00 / $1,318.26	Professional		$741.31	$1,000.00	$1,318.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $6,165.95	Facility		$3,715.35	$3,715.35	$6,165.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $10,471.29 / $23,988.33	Facility		$5,011.87	$10,471.29	$23,988.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $7,943.28 / $11,481.54	Professional		$5,248.07	$7,943.28	$11,481.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $64.57	Professional		$44.67	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $3,090.30 / $4,786.30	Facility		$1,479.11	$3,090.30	$4,786.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $1,659.59	Facility		$1,202.26	$1,659.59	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,862.09 / $2,884.03	Professional		$1,202.26	$1,862.09	$2,884.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $16,218.10 / $30,902.95	Facility		$10,715.19	$16,218.10	$30,902.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,995.26 / $2,754.23	Professional		$1,318.26	$1,995.26	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $19,498.45 / $33,884.42	Facility		$2,454.71	$19,498.45	$33,884.42
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,819.70 / $2,754.23	Professional		$1,096.48	$1,819.70	$2,754.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $602.56 / $2,511.89	Professional		$316.23	$602.56	$2,511.89