Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,311.31 / $20,892.96	Facility		$2,344.23	$3,311.31	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,621.81 / $3,801.89	Professional		$1,230.27	$1,621.81	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,344.23 / $3,801.89	Professional		$1,621.81	$2,344.23	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,754.23 / $3,467.37	Facility		$1,584.89	$2,754.23	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,754.23 / $3,467.37	Professional		$1,584.89	$2,754.23	$3,467.37
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 $2,137.96 / $2,454.71 / $2,570.40	Facility		$2,137.96	$2,454.71	$2,570.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,884.03 / $3,715.35	Professional		$1,737.80	$2,884.03	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,511.89 / $3,388.44	Professional		$1,778.28	$2,511.89	$3,388.44
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 $1,348.96 / $1,905.46 / $3,548.13	Professional		$1,348.96	$1,905.46	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $2,344.23	Professional		$1,412.54	$1,659.59	$2,344.23