Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $7,943.28 / $20,892.96	Facility		$2,290.87	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $3,388.44	Professional		$1,071.52	$1,412.54	$3,388.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,290.87 / $3,630.78	Professional		$1,412.54	$2,290.87	$3,630.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,818.38 / $13,803.84	Facility		$1,659.59	$2,818.38	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,630.27 / $4,168.69	Professional		$1,548.82	$2,630.27	$4,168.69
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 $1,949.84 / $2,344.23 / $2,454.71	Facility		$1,949.84	$2,344.23	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $3,548.13	Professional		$1,659.59	$2,754.23	$3,548.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $14,125.38 / $26,915.35	Facility		$10,000.00	$14,125.38	$26,915.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,344.23 / $3,162.28	Professional		$1,659.59	$2,344.23	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $17,782.79 / $30,199.52	Facility		$3,467.37	$17,782.79	$30,199.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,905.46 / $3,467.37	Professional		$1,174.90	$1,905.46	$3,467.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $1,995.26	Professional		$1,071.52	$1,445.44	$1,995.26