Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,677.35 / $20,892.96	Facility		$2,818.38	$4,677.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,290.87 / $5,495.41	Professional		$1,778.28	$2,290.87	$5,495.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,311.31 / $5,248.07	Professional		$2,238.72	$3,311.31	$5,248.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,890.45 / $4,897.79	Facility		$2,238.72	$3,890.45	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,890.45 / $4,897.79	Professional		$2,238.72	$3,890.45	$4,897.79
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 $2,951.21 / $3,467.37 / $3,630.78	Facility		$2,951.21	$3,467.37	$3,630.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Facility		$2,454.71	$2,454.71	$2,454.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $4,073.80 / $5,248.07	Professional		$2,454.71	$4,073.80	$5,248.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,548.13 / $4,786.30	Professional		$2,511.89	$3,548.13	$4,786.30
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 $1,905.46 / $2,754.23 / $5,011.87	Professional		$1,905.46	$2,754.23	$5,011.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,290.87 / $3,235.94	Professional		$1,949.84	$2,290.87	$3,235.94