Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,754.23 / $20,892.96	Facility		$1,737.80	$2,754.23	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,202.26 / $2,754.23	Professional		$891.25	$1,202.26	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,862.09 / $2,754.23	Professional		$1,230.27	$1,862.09	$2,754.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $2,630.27	Facility		$1,202.26	$2,041.74	$2,630.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $2,630.27	Professional		$1,202.26	$2,041.74	$2,630.27
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 $1,548.82 / $1,819.70 / $1,905.46	Facility		$1,548.82	$1,819.70	$1,905.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,137.96 / $2,754.23	Professional		$1,288.25	$2,137.96	$2,754.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $2,511.89	Professional		$1,318.26	$1,862.09	$2,511.89
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 $1,023.29 / $1,548.82 / $2,630.27	Professional		$1,023.29	$1,548.82	$2,630.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,174.90 / $1,659.59	Professional		$1,000.00	$1,174.90	$1,659.59