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 $1,584.89 / $1,995.26 / $5,128.61	Professional		$1,584.89	$1,995.26	$5,128.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,019.95 / $4,570.88	Professional		$2,089.30	$3,019.95	$4,570.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,388.44 / $4,677.35	Facility		$2,137.96	$3,388.44	$4,677.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,388.44 / $4,570.88	Professional		$2,137.96	$3,388.44	$4,570.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,019.95 / $3,467.37	Facility		$2,630.27	$3,019.95	$3,467.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,187.76	Facility		$2,137.96	$2,137.96	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,548.13 / $4,677.35	Professional		$2,187.76	$3,548.13	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,090.30 / $4,168.69	Professional		$2,187.76	$3,090.30	$4,168.69
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 $1,698.24 / $2,511.89 / $4,365.16	Professional		$1,698.24	$2,511.89	$4,365.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,949.84 / $2,754.23	Professional		$1,659.59	$1,949.84	$2,754.23