Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,388.44 / $20,892.96	Facility		$2,454.71	$3,388.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,659.59 / $4,073.80	Professional		$1,288.25	$1,659.59	$4,073.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,454.71 / $3,890.45	Professional		$1,659.59	$2,454.71	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,818.38 / $3,630.78	Facility		$1,621.81	$2,818.38	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,818.38 / $3,630.78	Professional		$1,621.81	$2,818.38	$3,630.78
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 $2,187.76 / $2,511.89 / $2,630.27	Facility		$2,187.76	$2,511.89	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,819.70	Facility		$1,778.28	$1,778.28	$1,819.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,951.21 / $3,890.45	Professional		$1,819.70	$2,951.21	$3,890.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $3,467.37	Professional		$1,819.70	$2,630.27	$3,467.37
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 $1,380.38 / $1,995.26 / $3,630.78	Professional		$1,380.38	$1,995.26	$3,630.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,698.24 / $2,398.83	Professional		$1,445.44	$1,698.24	$2,398.83