Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $11,220.18 / $25,118.86	Facility		$2,344.23	$11,220.18	$25,118.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,041.74 / $3,019.95	Professional		$1,659.59	$2,041.74	$3,019.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $5,623.41 / $6,456.54	Facility		$2,630.27	$5,623.41	$6,456.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $11,748.98	Facility		$2,511.89	$2,511.89	$11,748.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,511.89 / $4,265.80	Professional		$1,995.26	$2,511.89	$4,265.80
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 $2,238.72 / $2,754.23 / $4,365.16	Facility		$2,238.72	$2,754.23	$4,365.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,365.16 / $7,585.78	Facility		$2,511.89	$4,365.16	$7,585.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $3,019.95	Professional		$2,238.72	$2,238.72	$3,019.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,801.89 / $6,918.31	Facility		$2,630.27	$3,801.89	$6,918.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,238.72 / $2,818.38	Professional		$2,137.96	$2,238.72	$2,818.38
United Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $3,019.95 / $3,019.95	Facility		$2,511.89	$3,019.95	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,174.90 / $2,818.38	Professional		$1,047.13	$1,174.90	$2,818.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $2,511.89 / $4,466.84	Professional		$1,122.02	$2,511.89	$4,466.84