Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,715.35 / $20,892.96	Facility		$2,630.27	$3,715.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,737.80 / $4,365.16	Professional		$1,412.54	$1,737.80	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $4,265.80	Professional		$1,819.70	$2,630.27	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,090.30 / $3,890.45	Facility		$1,778.28	$3,090.30	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $3,090.30 / $3,890.45	Professional		$1,778.28	$3,090.30	$3,890.45
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 $2,398.83 / $2,754.23 / $2,884.03	Facility		$2,398.83	$2,754.23	$2,884.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,995.26	Facility		$1,949.84	$1,949.84	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,235.94 / $4,168.69	Professional		$1,995.26	$3,235.94	$4,168.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,818.38 / $3,801.89	Professional		$1,995.26	$2,818.38	$3,801.89
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 $1,513.56 / $2,187.76 / $3,981.07	Professional		$1,513.56	$2,187.76	$3,981.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,862.09 / $2,630.27	Professional		$1,584.89	$1,862.09	$2,630.27