Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $7,943.28 / $20,892.96	Facility		$2,137.96	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,288.25 / $3,162.28	Professional		$1,000.00	$1,288.25	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,137.96 / $3,467.37	Professional		$1,348.96	$2,137.96	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,691.53 / $20,892.96	Facility		$1,548.82	$2,691.53	$20,892.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,511.89 / $5,888.44	Professional		$1,479.11	$2,511.89	$5,888.44
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 $1,862.09 / $2,238.72 / $2,344.23	Facility		$1,862.09	$2,238.72	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,584.89	Facility		$1,548.82	$1,548.82	$1,584.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,630.27 / $3,388.44	Professional		$1,584.89	$2,630.27	$3,388.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,454.40 / $21,379.62 / $40,738.03	Facility		$14,454.40	$21,379.62	$40,738.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,238.72 / $3,019.95	Professional		$1,584.89	$2,238.72	$3,019.95
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $25,703.96 / $44,668.36	Facility		$3,467.37	$25,703.96	$44,668.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,819.70 / $3,311.31	Professional		$1,122.02	$1,819.70	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,348.96 / $1,905.46	Professional		$1,000.00	$1,348.96	$1,905.46