Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,388.44 / $20,892.96	Facility		$2,290.87	$3,388.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,584.89 / $3,801.89	Professional		$1,230.27	$1,584.89	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,344.23 / $3,715.35	Professional		$1,584.89	$2,344.23	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,691.53 / $3,467.37	Facility		$1,548.82	$2,691.53	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,691.53 / $3,467.37	Professional		$1,548.82	$2,691.53	$3,467.37
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 $2,089.30 / $2,398.83 / $2,570.40	Facility		$2,089.30	$2,398.83	$2,570.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,737.80	Facility		$1,698.24	$1,698.24	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,818.38 / $3,715.35	Professional		$1,737.80	$2,818.38	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,454.71 / $3,311.31	Professional		$1,737.80	$2,454.71	$3,311.31
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 $1,318.26 / $1,862.09 / $3,467.37	Professional		$1,318.26	$1,862.09	$3,467.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,621.81 / $2,290.87	Professional		$1,380.38	$1,621.81	$2,290.87