Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,495.41 / $20,892.96	Facility		$2,818.38	$5,495.41	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,691.53 / $6,456.54	Professional		$1,995.26	$2,691.53	$6,456.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,981.07 / $6,165.95	Professional		$2,570.40	$3,981.07	$6,165.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $4,570.88 / $5,888.44	Facility		$2,630.27	$4,570.88	$5,888.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $4,570.88 / $5,888.44	Professional		$2,630.27	$4,570.88	$5,888.44
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 $3,548.13 / $4,073.80 / $4,466.84	Facility		$3,548.13	$4,073.80	$4,466.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,951.21	Facility		$2,884.03	$2,884.03	$2,951.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,786.30 / $6,165.95	Professional		$2,951.21	$4,786.30	$6,165.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,168.69 / $5,623.41	Professional		$2,951.21	$4,168.69	$5,623.41
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 $2,238.72 / $3,235.94 / $5,888.44	Professional		$2,238.72	$3,235.94	$5,888.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,630.27 / $3,715.35	Professional		$2,238.72	$2,630.27	$3,715.35