Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $6,025.60 / $13,489.63	Facility		$1,258.93	$6,025.60	$13,489.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,071.52 / $1,584.89	Professional		$794.33	$1,071.52	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $2,951.21 / $3,467.37	Facility		$1,380.38	$2,951.21	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,348.96 / $6,165.95	Facility		$1,202.26	$1,348.96	$6,165.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,348.96 / $2,290.87	Professional		$1,071.52	$1,348.96	$2,290.87
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 $1,348.96 / $1,348.96 / $1,862.09	Facility		$1,348.96	$1,348.96	$1,862.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,344.23 / $3,981.07	Facility		$1,348.96	$2,344.23	$3,981.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,621.81	Professional		$1,202.26	$1,202.26	$1,621.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,995.26 / $3,715.35	Facility		$1,412.54	$1,995.26	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,202.26 / $1,513.56	Professional		$1,148.15	$1,202.26	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,621.81 / $1,621.81	Facility		$1,348.96	$1,621.81	$1,621.81
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $1,513.56	Professional		$562.34	$562.34	$1,513.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,348.96 / $2,398.83	Professional		$602.56	$1,348.96	$2,398.83