Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $7,943.28 / $24,547.09	Facility		$1,513.56	$7,943.28	$24,547.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $2,238.72	Professional		$758.58	$977.24	$2,238.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,513.56 / $2,398.83	Professional		$912.01	$1,513.56	$2,398.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,621.81 / $2,041.74	Facility		$933.25	$1,621.81	$2,041.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,621.81 / $2,089.30	Professional		$977.24	$1,621.81	$2,089.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,513.56 / $1,621.81	Facility		$1,288.25	$1,513.56	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,096.48	Facility		$1,071.52	$1,071.52	$1,096.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,819.70 / $2,344.23	Professional		$1,096.48	$1,819.70	$2,344.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,548.82 / $2,089.30	Professional		$1,096.48	$1,548.82	$2,089.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,019.95 / $5,495.41	Facility		$1,995.26	$3,019.95	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,258.93 / $2,290.87	Professional		$776.25	$1,258.93	$2,290.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $977.24 / $1,380.38	Professional		$724.44	$977.24	$1,380.38