Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,801.89 / $20,892.96	Facility		$2,691.53	$3,801.89	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,819.70 / $4,677.35	Professional		$1,479.11	$1,819.70	$4,677.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,818.38 / $4,265.80	Professional		$1,778.28	$2,818.38	$4,265.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,162.28 / $4,073.80	Facility		$1,819.70	$3,162.28	$4,073.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,162.28 / $4,073.80	Professional		$1,819.70	$3,162.28	$4,073.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,754.23 / $2,951.21	Facility		$2,398.83	$2,754.23	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,311.31 / $4,265.80	Professional		$1,995.26	$3,311.31	$4,265.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,884.03 / $3,890.45	Professional		$2,041.74	$2,884.03	$3,890.45
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 $1,584.89 / $2,290.87 / $4,073.80	Professional		$1,584.89	$2,290.87	$4,073.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,778.28 / $2,511.89	Professional		$1,513.56	$1,778.28	$2,511.89