Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,041.74 / $20,892.96	Facility		$1,348.96	$2,041.74	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $891.25 / $2,041.74	Professional		$645.65	$891.25	$2,041.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,348.96 / $2,187.76	Professional		$891.25	$1,348.96	$2,187.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,513.56 / $1,819.70	Facility		$891.25	$1,513.56	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,513.56 / $1,862.09	Professional		$912.01	$1,513.56	$1,862.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,412.54 / $1,479.11	Facility		$1,122.02	$1,412.54	$1,479.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,000.00	Facility		$977.24	$977.24	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,659.59 / $2,137.96	Professional		$1,000.00	$1,659.59	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,445.44 / $1,862.09	Professional		$1,000.00	$1,445.44	$1,862.09
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 $724.44 / $1,148.15 / $2,089.30	Professional		$724.44	$1,148.15	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $977.24 / $1,380.38	Professional		$724.44	$977.24	$1,380.38