Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $6,025.60 / $21,877.62	Facility		$3,162.28	$6,025.60	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,090.30 / $6,456.54	Professional		$2,398.83	$3,090.30	$6,456.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,570.88 / $7,244.36	Professional		$3,019.95	$4,570.88	$7,244.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,248.07 / $6,606.93	Facility		$3,090.30	$5,248.07	$6,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $5,248.07 / $6,606.93	Professional		$3,090.30	$5,248.07	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,677.35 / $5,011.87	Facility		$4,073.80	$4,677.35	$5,011.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Facility		$3,388.44	$3,388.44	$3,388.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $5,623.41 / $7,244.36	Professional		$3,388.44	$5,623.41	$7,244.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,897.79 / $6,606.93	Professional		$3,467.37	$4,897.79	$6,606.93
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 $2,691.53 / $3,890.45 / $6,918.31	Professional		$2,691.53	$3,890.45	$6,918.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,019.95 / $4,265.80	Professional		$2,570.40	$3,019.95	$4,265.80