Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $7,943.28 / $20,892.96	Facility		$1,737.80	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,412.54 / $1,698.24	Professional		$1,047.13	$1,412.54	$1,698.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15,848.93 / $28,183.83 / $63,095.73	Facility		$15,848.93	$28,183.83	$63,095.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12,882.50 / $19,498.45 / $28,183.83	Professional		$12,882.50	$19,498.45	$28,183.83
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 $2,041.74 / $2,884.03 / $2,951.21	Facility		$2,041.74	$2,884.03	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,162.28 / $4,265.80	Professional		$1,995.26	$3,162.28	$4,265.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,187.76 / $4,168.69	Facility		$1,819.70	$2,187.76	$4,168.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,818.38 / $3,801.89	Professional		$1,949.84	$2,818.38	$3,801.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $45,708.82 / $79,432.82	Facility		$1,318.26	$45,708.82	$79,432.82
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,290.87 / $4,168.69	Professional		$1,584.89	$2,290.87	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Professional		$5,248.07	$5,248.07	$5,248.07