Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $10,232.93 / $28,183.83	Facility		$3,388.44	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,388.44 / $4,365.16	Professional		$2,570.40	$3,388.44	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $5,888.44 / $7,943.28	Professional		$4,073.80	$5,888.44	$7,943.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $6,025.60 / $7,079.46	Facility		$3,090.30	$6,025.60	$7,079.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $6,025.60 / $7,585.78	Professional		$3,090.30	$6,025.60	$7,585.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $60.26	Professional		$44.67	$50.12	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $5,128.61 / $5,495.41	Facility		$4,365.16	$5,128.61	$5,495.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Facility		$3,548.13	$3,548.13	$3,548.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $5,888.44 / $8,511.38	Professional		$3,548.13	$5,888.44	$8,511.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $5,495.41 / $7,762.47	Professional		$3,548.13	$5,495.41	$7,762.47
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 $2,398.83 / $3,630.78 / $7,244.36	Professional		$2,398.83	$3,630.78	$7,244.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Professional		$4,168.69	$4,168.69	$4,168.69