Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,715.35 / $20,892.96	Facility		$2,691.53	$3,715.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,819.70 / $4,265.80	Professional		$1,412.54	$1,819.70	$4,265.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,691.53 / $4,365.16	Professional		$1,778.28	$2,691.53	$4,365.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,162.28 / $3,981.07	Facility		$1,778.28	$3,162.28	$3,981.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $3,162.28 / $3,981.07	Professional		$1,778.28	$3,162.28	$3,981.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $81.28	Professional		$32.36	$33.11	$81.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,454.71 / $2,951.21	Facility		$2,137.96	$2,454.71	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,235.94 / $3,801.89	Professional		$1,995.26	$3,235.94	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,884.03 / $3,890.45	Professional		$1,995.26	$2,884.03	$3,890.45
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 $1,479.11 / $2,137.96 / $3,981.07	Professional		$1,479.11	$2,137.96	$3,981.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,584.89 / $2,238.72	Professional		$1,348.96	$1,584.89	$2,238.72