Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,466.84 / $20,892.96	Facility		$2,818.38	$4,466.84	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $5,370.32	Professional		$1,698.24	$2,137.96	$5,370.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,162.28 / $5,011.87	Professional		$2,089.30	$3,162.28	$5,011.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,630.78 / $4,677.35	Facility		$2,137.96	$3,630.78	$4,677.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,630.78 / $4,677.35	Professional		$2,137.96	$3,630.78	$4,677.35
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 $2,818.38 / $3,235.94 / $3,548.13	Facility		$2,818.38	$3,235.94	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility		$2,344.23	$2,344.23	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,890.45 / $5,011.87	Professional		$2,344.23	$3,890.45	$5,011.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,388.44 / $4,570.88	Professional		$2,398.83	$3,388.44	$4,570.88
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 $1,862.09 / $2,691.53 / $4,786.30	Professional		$1,862.09	$2,691.53	$4,786.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,089.30 / $2,951.21	Professional		$1,778.28	$2,089.30	$2,951.21