Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $9,549.93 / $21,379.62	Facility		$1,995.26	$9,549.93	$21,379.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,737.80 / $2,691.53	Professional		$1,412.54	$1,737.80	$2,691.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $4,677.35 / $5,495.41	Facility		$2,187.76	$4,677.35	$5,495.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $3,388.44	Facility		$1,698.24	$2,137.96	$3,388.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $3,630.78	Professional		$1,698.24	$2,137.96	$3,630.78
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 $1,905.46 / $2,344.23 / $3,715.35	Facility		$1,905.46	$2,344.23	$3,715.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,715.35 / $6,309.57	Facility		$2,137.96	$3,715.35	$6,309.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $2,570.40	Professional		$1,905.46	$1,905.46	$2,570.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,162.28 / $5,888.44	Facility		$2,238.72	$3,162.28	$5,888.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,905.46 / $2,398.83	Professional		$1,819.70	$1,905.46	$2,398.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,570.40 / $2,570.40	Facility		$2,137.96	$2,570.40	$2,570.40
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $2,398.83	Professional		$891.25	$891.25	$2,398.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $2,137.96 / $3,801.89	Professional		$954.99	$2,137.96	$3,801.89