Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $6,025.60 / $20,892.96	Facility		$2,951.21	$6,025.60	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,951.21 / $7,413.10	Professional		$2,344.23	$2,951.21	$7,413.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,365.16 / $6,918.31	Professional		$2,884.03	$4,365.16	$6,918.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,011.87 / $6,606.93	Facility		$2,951.21	$5,011.87	$6,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $5,011.87 / $6,606.93	Professional		$2,951.21	$5,011.87	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $4,466.84 / $5,011.87	Facility		$3,890.45	$4,466.84	$5,011.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,235.94 / $3,235.94	Facility		$3,235.94	$3,235.94	$3,235.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $5,370.32 / $6,918.31	Professional		$3,235.94	$5,370.32	$6,918.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,677.35 / $6,309.57	Professional		$3,311.31	$4,677.35	$6,309.57
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 $2,570.40 / $3,715.35 / $6,606.93	Professional		$2,570.40	$3,715.35	$6,606.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,884.03 / $4,073.80	Professional		$2,454.71	$2,884.03	$4,073.80