Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,818.38 / $20,892.96	Facility		$1,995.26	$2,818.38	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $3,235.94	Professional		$1,047.13	$1,318.26	$3,235.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,995.26 / $3,162.28	Professional		$1,348.96	$1,995.26	$3,162.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,290.87 / $2,951.21	Facility		$1,318.26	$2,290.87	$2,951.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,290.87 / $2,951.21	Professional		$1,318.26	$2,290.87	$2,951.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $67.61	Professional		$32.36	$33.11	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,041.74 / $2,137.96	Facility		$1,778.28	$2,041.74	$2,137.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,479.11	Facility		$1,445.44	$1,445.44	$1,479.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,398.83 / $3,162.28	Professional		$1,479.11	$2,398.83	$3,162.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,137.96 / $2,884.03	Professional		$1,479.11	$2,137.96	$2,884.03
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 / $1,584.89 / $2,951.21	Professional		$1,122.02	$1,584.89	$2,951.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $1,949.84	Professional		$1,174.90	$1,380.38	$1,949.84