Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,897.79 / $20,892.96	Facility		$2,818.38	$4,897.79	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,570.40 / $6,025.60	Professional		$1,949.84	$2,570.40	$6,025.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,715.35 / $5,888.44	Professional		$2,454.71	$3,715.35	$5,888.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,265.80 / $5,495.41	Facility		$2,511.89	$4,265.80	$5,495.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $4,265.80 / $5,495.41	Professional		$2,511.89	$4,265.80	$5,495.41
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 $3,311.31 / $3,801.89 / $4,073.80	Facility		$3,311.31	$3,801.89	$4,073.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility		$2,754.23	$2,754.23	$2,754.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,570.88 / $5,888.44	Professional		$2,754.23	$4,570.88	$5,888.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $3,981.07 / $5,370.32	Professional		$2,818.38	$3,981.07	$5,370.32
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 $1,905.46 / $3,019.95 / $5,623.41	Professional		$1,905.46	$3,019.95	$5,623.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,511.89 / $3,548.13	Professional		$2,137.96	$2,511.89	$3,548.13