Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $7,762.47 / $17,378.01	Facility		$1,621.81	$7,762.47	$17,378.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,380.38 / $1,698.24	Professional		$1,047.13	$1,380.38	$1,698.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,890.45 / $4,466.84	Facility		$1,819.70	$3,890.45	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,737.80 / $8,128.31	Facility		$1,548.82	$1,737.80	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,737.80 / $2,951.21	Professional		$1,380.38	$1,737.80	$2,951.21
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 $1,737.80 / $1,737.80 / $3,019.95	Facility		$1,737.80	$1,737.80	$3,019.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,019.95 / $5,248.07	Facility		$1,737.80	$3,019.95	$5,248.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $2,089.30	Professional		$1,548.82	$1,548.82	$2,089.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $4,786.30	Facility		$1,819.70	$2,630.27	$4,786.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,548.82 / $1,949.84	Professional		$1,479.11	$1,548.82	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,089.30 / $2,089.30	Facility		$1,737.80	$2,089.30	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $1,949.84	Professional		$724.44	$724.44	$1,949.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,737.80 / $3,162.28	Professional		$776.25	$1,737.80	$3,162.28