Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,128.61 / $20,892.96	Facility		$2,818.38	$5,128.61	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,454.71 / $5,370.32	Professional		$1,905.46	$2,454.71	$5,370.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,801.89 / $6,165.95	Professional		$2,398.83	$3,801.89	$6,165.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,168.69 / $5,128.61	Facility		$2,511.89	$4,168.69	$5,128.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $4,168.69 / $5,248.07	Professional		$2,570.40	$4,168.69	$5,248.07
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 $3,019.95 / $3,890.45 / $4,073.80	Facility		$3,019.95	$3,890.45	$4,073.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,754.23	Facility		$2,691.53	$2,691.53	$2,754.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,570.88 / $5,888.44	Professional		$2,754.23	$4,570.88	$5,888.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,981.07 / $5,128.61	Professional		$2,754.23	$3,981.07	$5,128.61
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,454.71 / $37,153.52	Facility		$707.95	$2,454.71	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,162.28 / $5,754.40	Professional		$1,995.26	$3,162.28	$5,754.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,344.23 / $3,311.31	Professional		$1,737.80	$2,344.23	$3,311.31