Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $5,754.40 / $20,892.96	Facility		$2,884.03	$5,754.40	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,884.03 / $6,918.31	Professional		$2,137.96	$2,884.03	$6,918.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,168.69 / $6,606.93	Professional		$2,754.23	$4,168.69	$6,606.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,897.79 / $6,309.57	Facility		$2,818.38	$4,897.79	$6,309.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $4,897.79 / $6,309.57	Professional		$2,818.38	$4,897.79	$6,309.57
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 $3,715.35 / $4,265.80 / $4,786.30	Facility		$3,715.35	$4,265.80	$4,786.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Facility		$3,090.30	$3,090.30	$3,090.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $5,128.61 / $6,606.93	Professional		$3,090.30	$5,128.61	$6,606.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,466.84 / $6,025.60	Professional		$3,162.28	$4,466.84	$6,025.60
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 $2,344.23 / $3,467.37 / $6,309.57	Professional		$2,344.23	$3,467.37	$6,309.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,818.38 / $3,981.07	Professional		$2,398.83	$2,818.38	$3,981.07