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 $1,819.70 / $2,290.87 / $5,888.44	Professional		$1,819.70	$2,290.87	$5,888.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,388.44 / $5,370.32	Professional		$2,238.72	$3,388.44	$5,370.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,890.45 / $5,128.61	Facility		$2,290.87	$3,890.45	$5,128.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,890.45 / $5,128.61	Professional		$2,290.87	$3,890.45	$5,128.61
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 $3,019.95 / $3,467.37 / $3,715.35	Facility		$3,019.95	$3,467.37	$3,715.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $4,168.69 / $5,370.32	Professional		$2,511.89	$4,168.69	$5,370.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,630.78 / $4,897.79	Professional		$2,570.40	$3,630.78	$4,897.79
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 $1,995.26 / $2,884.03 / $5,128.61	Professional		$1,995.26	$2,884.03	$5,128.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,238.72 / $3,162.28	Professional		$1,905.46	$2,238.72	$3,162.28