Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,715.35 / $20,892.96	Facility		$2,691.53	$3,715.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,737.80 / $3,890.45	Professional		$1,348.96	$1,737.80	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,691.53 / $4,265.80	Professional		$1,737.80	$2,691.53	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,951.21 / $3,630.78	Facility		$1,778.28	$2,951.21	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,019.95 / $3,630.78	Professional		$1,819.70	$3,019.95	$3,630.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,754.23 / $2,951.21	Facility		$2,398.83	$2,754.23	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,995.26	Facility		$1,949.84	$1,949.84	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,311.31 / $4,265.80	Professional		$1,995.26	$3,311.31	$4,265.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,884.03 / $3,715.35	Professional		$1,995.26	$2,884.03	$3,715.35
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 $1,445.44 / $2,344.23 / $4,168.69	Professional		$1,445.44	$2,344.23	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,862.09 / $2,630.27	Professional		$1,380.38	$1,862.09	$2,630.27