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 $1,023.29 / $1,348.96 / $3,630.78	Professional		$1,023.29	$1,348.96	$3,630.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,089.30 / $9,549.93	Facility		$1,412.54	$2,089.30	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,089.30 / $3,235.94	Professional		$1,412.54	$2,089.30	$3,235.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $660.69	Professional		$32.36	$33.11	$660.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,187.76 / $2,290.87	Facility		$1,659.59	$2,187.76	$2,290.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,513.56 / $1,548.82	Facility		$1,445.44	$1,513.56	$1,548.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,570.40 / $3,311.31	Professional		$1,548.82	$2,570.40	$3,311.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $10,964.78 / $20,892.96	Facility		$7,943.28	$10,964.78	$20,892.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,290.87 / $3,467.37	Professional		$1,513.56	$2,290.87	$3,467.37
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $12,022.64 / $22,387.21	Facility		$2,137.96	$12,022.64	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,698.24 / $3,162.28	Professional		$1,174.90	$1,698.24	$3,162.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $1,348.96 / $1,905.46	Professional		$151.36	$1,348.96	$1,905.46