Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $21,379.62 / $47,863.01	Facility		$4,466.84	$21,379.62	$47,863.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,890.45 / $5,754.40	Professional		$3,162.28	$3,890.45	$5,754.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $10,715.19 / $12,302.69	Facility		$5,011.87	$10,715.19	$12,302.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,786.30 / $22,387.21	Facility		$4,265.80	$4,786.30	$22,387.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $4,786.30 / $8,128.31	Professional		$3,801.89	$4,786.30	$8,128.31
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 $4,265.80 / $5,248.07 / $8,317.64	Facility		$4,265.80	$5,248.07	$8,317.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $8,317.64 / $14,454.40	Facility		$4,786.30	$8,317.64	$14,454.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $5,754.40	Professional		$4,265.80	$4,265.80	$5,754.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $7,244.36 / $13,182.57	Facility		$5,011.87	$7,244.36	$13,182.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,265.80 / $5,370.32	Professional		$4,073.80	$4,265.80	$5,370.32
United Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $5,754.40 / $5,754.40	Facility		$4,786.30	$5,754.40	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $5,370.32	Professional		$1,995.26	$1,995.26	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $4,786.30 / $8,511.38	Professional		$2,137.96	$4,786.30	$8,511.38