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 $1,737.80 / $2,344.23 / $5,011.87	Professional		$1,737.80	$2,344.23	$5,011.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,467.37 / $5,495.41	Professional		$2,344.23	$3,467.37	$5,495.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $4,073.80 / $5,248.07	Facility		$2,398.83	$4,073.80	$5,248.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $4,073.80 / $5,248.07	Professional		$2,398.83	$4,073.80	$5,248.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,630.78 / $3,801.89	Facility		$3,090.30	$3,630.78	$3,801.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Facility		$2,570.40	$2,570.40	$2,570.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $4,265.80 / $5,495.41	Professional		$2,570.40	$4,265.80	$5,495.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,715.35 / $5,011.87	Professional		$2,630.27	$3,715.35	$5,011.87
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 $2,041.74 / $3,311.31 / $5,370.32	Professional		$2,041.74	$3,311.31	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,344.23 / $3,311.31	Professional		$1,995.26	$2,344.23	$3,311.31