Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,570.88 / $20,892.96	Facility		$2,818.38	$4,570.88	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,238.72 / $6,025.60	Professional		$1,621.81	$2,238.72	$6,025.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,311.31 / $5,248.07	Professional		$2,238.72	$3,311.31	$5,248.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,801.89 / $4,897.79	Facility		$2,238.72	$3,801.89	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,801.89 / $4,897.79	Professional		$2,238.72	$3,801.89	$4,897.79
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 $2,951.21 / $3,388.44 / $3,548.13	Facility		$2,951.21	$3,388.44	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,454.71	Facility		$2,398.83	$2,398.83	$2,454.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,981.07 / $5,248.07	Professional		$2,454.71	$3,981.07	$5,248.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,548.13 / $4,786.30	Professional		$2,454.71	$3,548.13	$4,786.30
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 / $2,691.53 / $5,011.87	Professional		$1,905.46	$2,691.53	$5,011.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,238.72 / $3,162.28	Professional		$1,905.46	$2,238.72	$3,162.28