Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $10,232.93 / $28,183.83	Facility		$4,677.35	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $5,248.07 / $9,772.37	Professional		$3,548.13	$5,248.07	$9,772.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $7,943.28 / $12,022.64	Professional		$5,754.40	$7,943.28	$12,022.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $7,943.28 / $20,417.38	Facility		$3,801.89	$7,943.28	$20,417.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,715.35 / $7,943.28 / $10,232.93	Professional		$3,715.35	$7,943.28	$10,232.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $50.12	Professional		$44.67	$50.12	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $7,585.78 / $7,943.28	Facility		$5,495.41	$7,585.78	$7,943.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,128.61 / $5,128.61 / $5,370.32	Facility		$5,128.61	$5,128.61	$5,370.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $8,912.51 / $11,481.54	Professional		$5,370.32	$8,912.51	$11,481.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $14,454.40 / $26,915.35	Facility		$10,715.19	$14,454.40	$26,915.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $7,585.78 / $10,232.93	Professional		$5,248.07	$7,585.78	$10,232.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $17,782.79 / $34,673.69	Facility		$1,318.26	$17,782.79	$34,673.69
United Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $6,025.60 / $10,964.78	Professional		$3,801.89	$6,025.60	$10,964.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $5,128.61 / $7,244.36	Professional		$3,801.89	$5,128.61	$7,244.36