Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $10,232.93 / $28,183.83	Facility		$2,630.27	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $2,398.83 / $3,162.28	Professional		$1,096.48	$2,398.83	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $5,011.87 / $6,760.83	Professional		$3,467.37	$5,011.87	$6,760.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $3,162.28 / $4,897.79	Facility		$2,398.83	$3,162.28	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,162.28 / $4,677.35	Professional		$2,398.83	$3,162.28	$4,677.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $169.82 / $1,698.24	Professional		$64.57	$169.82	$1,698.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,621.81	Facility		$1,479.11	$1,479.11	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $3,019.95	Facility		$2,691.53	$2,691.53	$3,019.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,677.35 / $6,760.83	Professional		$3,019.95	$4,677.35	$6,760.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,265.80 / $5,888.44	Professional		$2,884.03	$4,265.80	$5,888.44
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 $1,621.81 / $2,511.89 / $4,677.35	Professional		$1,621.81	$2,511.89	$4,677.35
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