Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $7,762.47 / $20,892.96	Facility		$2,818.38	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,905.46 / $4,570.88	Professional		$1,513.56	$1,905.46	$4,570.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,235.94 / $5,248.07	Professional		$2,089.30	$3,235.94	$5,248.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,630.78 / $4,365.16	Facility		$2,041.74	$3,630.78	$4,365.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,630.78 / $4,466.84	Professional		$2,137.96	$3,630.78	$4,466.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,235.94 / $3,467.37	Facility		$2,454.71	$3,235.94	$3,467.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,398.83	Facility		$2,344.23	$2,344.23	$2,398.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,890.45 / $5,128.61	Professional		$2,398.83	$3,890.45	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,311.31 / $4,466.84	Professional		$2,344.23	$3,311.31	$4,466.84
United Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $7,244.36	Facility		$2,041.74	$2,041.74	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,691.53 / $4,897.79	Professional		$1,659.59	$2,691.53	$4,897.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,187.76 / $3,090.30	Professional		$1,621.81	$2,187.76	$3,090.30