Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $7,943.28 / $22,908.68	Facility		$1,819.70	$7,943.28	$22,908.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,148.15 / $2,570.40	Professional		$912.01	$1,148.15	$2,570.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,819.70 / $2,884.03	Professional		$1,174.90	$1,819.70	$2,884.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,290.87 / $15,488.17	Facility		$1,258.93	$2,290.87	$15,488.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,137.96 / $5,495.41	Professional		$1,230.27	$2,137.96	$5,495.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,905.46 / $1,949.84	Facility		$1,513.56	$1,905.46	$1,949.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,318.26	Facility		$1,288.25	$1,288.25	$1,318.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,187.76 / $2,818.38	Professional		$1,318.26	$2,187.76	$2,818.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $16,218.10 / $31,622.78	Facility		$10,715.19	$16,218.10	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $2,511.89	Professional		$1,318.26	$1,862.09	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $20,892.96 / $36,307.81	Facility		$4,265.80	$20,892.96	$36,307.81
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,548.82 / $2,754.23	Professional		$977.24	$1,548.82	$2,754.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,174.90 / $1,659.59	Professional		$870.96	$1,174.90	$1,659.59