Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,495.41 / $20,892.96	Facility		$2,818.38	$5,495.41	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,187.76 / $6,165.95	Professional		$1,862.09	$2,187.76	$6,165.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $4,073.80 / $6,456.54	Professional		$2,630.27	$4,073.80	$6,456.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $4,466.84 / $5,495.41	Facility		$2,691.53	$4,466.84	$5,495.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,570.88 / $5,623.41	Professional		$2,754.23	$4,570.88	$5,623.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,168.69 / $4,365.16	Facility		$3,311.31	$4,168.69	$4,365.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,951.21	Facility		$2,884.03	$2,884.03	$2,951.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,897.79 / $6,309.57	Professional		$2,951.21	$4,897.79	$6,309.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,168.69 / $5,623.41	Professional		$2,951.21	$4,168.69	$5,623.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $10,232.93	Facility		$2,570.40	$2,570.40	$10,232.93
United Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,467.37 / $6,309.57	Professional		$2,137.96	$3,467.37	$6,309.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,570.40 / $3,548.13	Professional		$1,862.09	$2,570.40	$3,548.13