Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $3,090.30 / $20,892.96	Facility		$2,089.30	$3,090.30	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,479.11 / $3,548.13	Professional		$1,148.15	$1,479.11	$3,548.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,137.96 / $3,311.31	Professional		$1,445.44	$2,137.96	$3,311.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,454.71 / $3,235.94	Facility		$1,479.11	$2,454.71	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,454.71 / $3,235.94	Professional		$1,479.11	$2,454.71	$3,235.94
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 $1,862.09 / $2,137.96 / $2,398.83	Facility		$1,862.09	$2,137.96	$2,398.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility		$1,548.82	$1,548.82	$1,548.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,570.40 / $3,311.31	Professional		$1,548.82	$2,570.40	$3,311.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,238.72 / $3,019.95	Professional		$1,584.89	$2,238.72	$3,019.95
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 / $1,819.70 / $3,162.28	Professional		$1,288.25	$1,819.70	$3,162.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,412.54 / $1,949.84	Professional		$1,202.26	$1,412.54	$1,949.84