Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $7,762.47 / $20,892.96	Facility		$2,290.87	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,513.56 / $3,388.44	Professional		$1,148.15	$1,513.56	$3,388.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,290.87 / $3,715.35	Professional		$1,445.44	$2,290.87	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,884.03 / $16,982.44	Facility		$1,659.59	$2,884.03	$16,982.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,691.53 / $4,466.84	Professional		$1,584.89	$2,691.53	$4,466.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,398.83 / $2,454.71	Facility		$2,041.74	$2,398.83	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,698.24	Facility		$1,659.59	$1,659.59	$1,698.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,818.38 / $3,548.13	Professional		$1,698.24	$2,818.38	$3,548.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $19,498.45 / $37,153.52	Facility		$12,882.50	$19,498.45	$37,153.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,398.83 / $3,162.28	Professional		$1,698.24	$2,398.83	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $24,547.09 / $42,657.95	Facility		$2,454.71	$24,547.09	$42,657.95
United Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,949.84 / $3,467.37	Professional		$1,202.26	$1,949.84	$3,467.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,412.54 / $1,995.26	Professional		$1,047.13	$1,412.54	$1,995.26