Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $3,388.44 / $20,892.96	Facility		$2,398.83	$3,388.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $3,467.37	Professional		$1,202.26	$1,584.89	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,454.71 / $3,890.45	Professional		$1,584.89	$2,454.71	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,691.53 / $3,311.31	Facility		$1,621.81	$2,691.53	$3,311.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $3,388.44	Professional		$1,659.59	$2,754.23	$3,388.44
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 $2,187.76 / $2,511.89 / $2,630.27	Facility		$2,187.76	$2,511.89	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,819.70	Facility		$1,778.28	$1,778.28	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,019.95 / $3,890.45	Professional		$1,819.70	$3,019.95	$3,890.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,570.40 / $3,388.44	Professional		$1,819.70	$2,570.40	$3,388.44
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 $1,318.26 / $2,137.96 / $3,801.89	Professional		$1,318.26	$2,137.96	$3,801.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,698.24 / $2,398.83	Professional		$1,258.93	$1,698.24	$2,398.83