Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $14,125.38 / $31,622.78	Facility		$2,951.21	$14,125.38	$31,622.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $2,511.89 / $3,090.30	Professional		$478.63	$2,511.89	$3,090.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $7,079.46 / $8,128.31	Facility		$3,311.31	$7,079.46	$8,128.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,162.28 / $14,791.08	Facility		$2,818.38	$3,162.28	$14,791.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,162.28 / $5,370.32	Professional		$2,511.89	$3,162.28	$5,370.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,467.37 / $5,495.41	Facility		$2,818.38	$3,467.37	$5,495.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $5,495.41 / $9,549.93	Facility		$3,162.28	$5,495.41	$9,549.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $3,801.89	Professional		$2,818.38	$2,818.38	$3,801.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,786.30 / $8,317.64	Facility		$3,311.31	$4,786.30	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,818.38 / $3,548.13	Professional		$2,691.53	$2,818.38	$3,548.13
United Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,801.89 / $3,801.89	Facility		$3,162.28	$3,801.89	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $3,548.13	Professional		$1,318.26	$1,318.26	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $3,162.28 / $5,623.41	Professional		$1,412.54	$3,162.28	$5,623.41