Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $8,128.31 / $25,703.96	Facility		$2,884.03	$8,128.31	$25,703.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,951.21 / $4,365.16	Professional		$2,344.23	$2,951.21	$4,365.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $7,943.28 / $9,332.54	Facility		$3,715.35	$7,943.28	$9,332.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,630.78 / $16,595.87	Facility		$3,235.94	$3,630.78	$16,595.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,630.78 / $6,165.95	Professional		$2,884.03	$3,630.78	$6,165.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,981.07 / $6,309.57	Facility		$3,235.94	$3,981.07	$6,309.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $6,309.57 / $10,715.19	Facility		$3,630.78	$6,309.57	$10,715.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $3,235.94 / $4,365.16	Professional		$3,235.94	$3,235.94	$4,365.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $5,370.32 / $10,000.00	Facility		$3,801.89	$5,370.32	$10,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,235.94 / $4,073.80	Professional		$3,090.30	$3,235.94	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $4,365.16 / $4,365.16	Facility		$3,630.78	$4,365.16	$4,365.16
United Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $4,073.80	Professional		$1,513.56	$1,513.56	$4,073.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $3,630.78 / $6,456.54	Professional		$1,621.81	$3,630.78	$6,456.54