Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,630.78 / $20,892.96	Facility		$2,570.40	$3,630.78	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,778.28 / $4,073.80	Professional		$1,380.38	$1,778.28	$4,073.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $4,073.80	Professional		$1,698.24	$2,570.40	$4,073.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,019.95 / $3,890.45	Facility		$1,737.80	$3,019.95	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $3,019.95 / $3,890.45	Professional		$1,737.80	$3,019.95	$3,890.45
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 $2,290.87 / $2,691.53 / $2,818.38	Facility		$2,290.87	$2,691.53	$2,818.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $3,162.28 / $4,073.80	Professional		$1,905.46	$3,162.28	$4,073.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,754.23 / $3,715.35	Professional		$1,949.84	$2,754.23	$3,715.35
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,311.31 / $37,153.52	Facility		$1,122.02	$3,311.31	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,089.30 / $3,890.45	Professional		$1,479.11	$2,089.30	$3,890.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,819.70 / $2,570.40	Professional		$1,548.82	$1,819.70	$2,570.40