Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,818.38 / $20,892.96	Facility		$1,995.26	$2,818.38	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,202.26 / $2,951.21	Professional		$933.25	$1,202.26	$2,951.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,995.26 / $3,162.28	Professional		$1,230.27	$1,995.26	$3,162.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,137.96 / $2,691.53	Facility		$1,288.25	$2,137.96	$2,691.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,187.76 / $2,691.53	Professional		$1,348.96	$2,187.76	$2,691.53
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 $1,548.82 / $2,041.74 / $2,137.96	Facility		$1,548.82	$2,041.74	$2,137.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility		$1,445.44	$1,445.44	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,398.83 / $3,090.30	Professional		$1,445.44	$2,398.83	$3,090.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,220.18 / $11,220.18 / $11,220.18	Facility		$11,220.18	$11,220.18	$11,220.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,041.74 / $2,754.23	Professional		$1,445.44	$2,041.74	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,388.44 / $7,244.36	Facility		$2,454.71	$3,388.44	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,659.59 / $3,019.95	Professional		$1,023.29	$1,659.59	$3,019.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,258.93 / $1,778.28	Professional		$933.25	$1,258.93	$1,778.28