Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $7,943.28 / $20,892.96	Facility		$2,818.38	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,041.74 / $5,128.61	Professional		$1,659.59	$2,041.74	$5,128.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,548.13 / $5,754.40	Professional		$2,187.76	$3,548.13	$5,754.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,365.16 / $15,848.93	Facility		$2,570.40	$4,365.16	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $4,073.80 / $5,754.40	Professional		$2,398.83	$4,073.80	$5,754.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $3,630.78 / $3,801.89	Facility		$2,754.23	$3,630.78	$3,801.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,570.40	Facility		$2,511.89	$2,511.89	$2,570.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $4,265.80 / $5,495.41	Professional		$2,570.40	$4,265.80	$5,495.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $16,595.87 / $31,622.78	Facility		$10,964.78	$16,595.87	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,630.78 / $4,786.30	Professional		$2,570.40	$3,630.78	$4,786.30
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $20,417.38 / $35,481.34	Facility		$3,467.37	$20,417.38	$35,481.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,951.21 / $5,370.32	Professional		$1,819.70	$2,951.21	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,187.76 / $3,090.30	Professional		$1,621.81	$2,187.76	$3,090.30