Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $3,890.45 / $20,892.96	Facility		$2,754.23	$3,890.45	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,905.46 / $4,265.80	Professional		$1,445.44	$1,905.46	$4,265.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,754.23 / $4,466.84	Professional		$1,862.09	$2,754.23	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,235.94 / $4,073.80	Facility		$1,862.09	$3,235.94	$4,073.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $3,235.94 / $4,073.80	Professional		$1,862.09	$3,235.94	$4,073.80
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 $2,454.71 / $2,884.03 / $3,019.95	Facility		$2,454.71	$2,884.03	$3,019.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility		$2,041.74	$2,041.74	$2,041.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,388.44 / $4,365.16	Professional		$2,041.74	$3,388.44	$4,365.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,951.21 / $3,981.07	Professional		$2,089.30	$2,951.21	$3,981.07
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 $1,584.89 / $2,238.72 / $4,168.69	Professional		$1,584.89	$2,238.72	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,905.46 / $2,691.53	Professional		$1,659.59	$1,905.46	$2,691.53