Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $13,182.57 / $28,840.32	Facility		$2,754.23	$13,182.57	$28,840.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,398.83 / $2,818.38	Professional		$1,905.46	$2,398.83	$2,818.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $6,456.54 / $7,585.78	Facility		$3,019.95	$6,456.54	$7,585.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,884.03 / $13,489.63	Facility		$2,630.27	$2,884.03	$13,489.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,884.03 / $5,011.87	Professional		$2,344.23	$2,884.03	$5,011.87
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 $2,630.27 / $3,235.94 / $5,128.61	Facility		$2,630.27	$3,235.94	$5,128.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $5,128.61 / $8,709.64	Facility		$2,884.03	$5,128.61	$8,709.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $3,467.37	Professional		$2,630.27	$2,630.27	$3,467.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,365.16 / $7,943.28	Facility		$3,090.30	$4,365.16	$7,943.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,630.27 / $3,235.94	Professional		$2,454.71	$2,630.27	$3,235.94
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,467.37 / $3,467.37	Facility		$2,884.03	$3,467.37	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $3,235.94	Professional		$1,230.27	$1,230.27	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,884.03 / $5,248.07	Professional		$1,318.26	$2,884.03	$5,248.07