Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $7,943.28 / $20,892.96	Facility		$2,454.71	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,479.11 / $3,715.35	Professional		$1,148.15	$1,479.11	$3,715.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,454.71 / $3,890.45	Professional		$1,513.56	$2,454.71	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,090.30 / $20,892.96	Facility		$1,778.28	$3,090.30	$20,892.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,818.38 / $5,888.44	Professional		$1,659.59	$2,818.38	$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 $2,137.96 / $2,511.89 / $2,630.27	Facility		$2,137.96	$2,511.89	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,819.70	Facility		$1,778.28	$1,778.28	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,019.95 / $3,801.89	Professional		$1,819.70	$3,019.95	$3,801.89
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 $1,819.70 / $2,570.40 / $3,388.44	Professional		$1,819.70	$2,570.40	$3,388.44
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 $1,288.25 / $2,089.30 / $3,801.89	Professional		$1,288.25	$2,089.30	$3,801.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $2,187.76	Professional		$1,148.15	$1,548.82	$2,187.76