Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $4,073.80 / $20,892.96	Facility		$2,454.71	$4,073.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,698.24 / $4,073.80	Professional		$1,380.38	$1,698.24	$4,073.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,691.53 / $3,981.07	Professional		$1,949.84	$2,691.53	$3,981.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,951.21 / $4,265.80	Facility		$1,995.26	$2,951.21	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,884.03 / $4,073.80	Professional		$1,995.26	$2,884.03	$4,073.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,511.89 / $3,162.28	Facility		$2,187.76	$2,511.89	$3,162.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$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 $1,862.09 / $2,630.27 / $3,548.13	Professional		$1,862.09	$2,630.27	$3,548.13
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 $1,445.44 / $2,344.23 / $3,715.35	Professional		$1,445.44	$2,344.23	$3,715.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $2,344.23	Professional		$1,412.54	$1,659.59	$2,344.23