Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,090.30 / $20,892.96	Facility		$2,187.76	$3,090.30	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,479.11 / $3,801.89	Professional		$1,174.90	$1,479.11	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,290.87 / $3,467.37	Professional		$1,445.44	$2,290.87	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,570.40 / $3,311.31	Facility		$1,479.11	$2,570.40	$3,311.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,570.40 / $3,311.31	Professional		$1,479.11	$2,570.40	$3,311.31
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 $1,995.26 / $2,290.87 / $2,398.83	Facility		$1,995.26	$2,290.87	$2,398.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,659.59	Facility		$1,621.81	$1,621.81	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,691.53 / $3,467.37	Professional		$1,659.59	$2,691.53	$3,467.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,344.23 / $3,162.28	Professional		$1,659.59	$2,344.23	$3,162.28
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 $1,288.25 / $1,862.09 / $3,311.31	Professional		$1,288.25	$1,862.09	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,479.11 / $2,089.30	Professional		$1,258.93	$1,479.11	$2,089.30