Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $7,079.46 / $21,877.62	Facility		$4,365.16	$7,079.46	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,467.37 / $7,244.36	Professional		$2,089.30	$3,467.37	$7,244.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $7,943.28 / $9,772.37	Facility		$3,890.45	$7,943.28	$9,772.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $4,365.16 / $5,248.07	Professional		$1,949.84	$4,365.16	$5,248.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,677.35 / $12,882.50	Facility		$3,715.35	$4,677.35	$12,882.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,715.35 / $4,677.35 / $10,471.29	Professional		$3,715.35	$4,677.35	$10,471.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $75.86	Professional		$64.57	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $7,079.46	Facility		$3,715.35	$3,715.35	$7,079.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $6,606.93 / $11,220.18	Facility		$3,715.35	$6,606.93	$11,220.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $4,466.84	Professional		$3,388.44	$3,388.44	$4,466.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $5,623.41 / $10,232.93	Facility		$3,981.07	$5,623.41	$10,232.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,388.44 / $4,168.69	Professional		$3,162.28	$3,388.44	$4,168.69
United Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,466.84 / $4,466.84	Facility		$3,715.35	$4,466.84	$4,466.84
United Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,584.89 / $4,168.69	Professional		$1,230.27	$1,584.89	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $3,715.35 / $6,760.83	Professional		$1,698.24	$3,715.35	$6,760.83