Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $7,943.28 / $20,892.96	Facility		$1,949.84	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,318.26 / $3,801.89	Professional		$1,000.00	$1,318.26	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,949.84 / $3,090.30	Professional		$1,288.25	$1,949.84	$3,090.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,238.72 / $2,754.23	Facility		$1,288.25	$2,238.72	$2,754.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,238.72 / $2,754.23	Professional		$1,288.25	$2,238.72	$2,754.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,995.26 / $2,089.30	Facility		$1,737.80	$1,995.26	$2,089.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility		$1,445.44	$1,445.44	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,344.23 / $3,090.30	Professional		$1,445.44	$2,344.23	$3,090.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,089.30 / $2,754.23	Professional		$1,445.44	$2,089.30	$2,754.23
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 $1,122.02 / $1,659.59 / $2,884.03	Professional		$1,122.02	$1,659.59	$2,884.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,230.27 / $1,737.80	Professional		$1,047.13	$1,230.27	$1,737.80