Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $3,801.89 / $20,892.96	Facility		$2,398.83	$3,801.89	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,621.81 / $3,890.45	Professional		$1,288.25	$1,621.81	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,570.40 / $3,801.89	Professional		$1,584.89	$2,570.40	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,754.23 / $3,548.13	Facility		$1,621.81	$2,754.23	$3,548.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,754.23 / $3,548.13	Professional		$1,621.81	$2,754.23	$3,548.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $79.43	Professional		$32.36	$33.11	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,454.71 / $2,818.38	Facility		$2,089.30	$2,454.71	$2,818.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,951.21 / $3,801.89	Professional		$1,778.28	$2,951.21	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,570.40 / $3,467.37	Professional		$1,778.28	$2,570.40	$3,467.37
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 $1,318.26 / $2,041.74 / $3,630.78	Professional		$1,318.26	$2,041.74	$3,630.78
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