Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,365.16 / $20,892.96	Facility		$2,818.38	$4,365.16	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,137.96 / $6,456.54	Professional		$1,659.59	$2,137.96	$6,456.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,090.30 / $4,897.79	Professional		$2,137.96	$3,090.30	$4,897.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $3,630.78 / $4,570.88	Facility		$2,089.30	$3,630.78	$4,570.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,630.78 / $4,570.88	Professional		$2,089.30	$3,630.78	$4,570.88
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 $2,754.23 / $3,235.94 / $3,388.44	Facility		$2,754.23	$3,235.94	$3,388.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility		$2,290.87	$2,290.87	$2,290.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,801.89 / $4,897.79	Professional		$2,290.87	$3,801.89	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,311.31 / $4,466.84	Professional		$2,344.23	$3,311.31	$4,466.84
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 $1,819.70 / $2,570.40 / $4,677.35	Professional		$1,819.70	$2,570.40	$4,677.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,137.96 / $3,019.95	Professional		$1,819.70	$2,137.96	$3,019.95