Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,388.44 / $20,892.96	Facility		$2,344.23	$3,388.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $3,981.07	Professional		$1,258.93	$1,621.81	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,344.23 / $3,715.35	Professional		$1,659.59	$2,344.23	$3,715.35
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 $2,041.74 / $2,398.83 / $2,630.27	Facility		$2,041.74	$2,398.83	$2,630.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,884.03 / $3,715.35	Professional		$1,737.80	$2,884.03	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,511.89 / $3,388.44	Professional		$1,778.28	$2,511.89	$3,388.44
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 $1,380.38 / $1,995.26 / $3,548.13	Professional		$1,380.38	$1,995.26	$3,548.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,513.56 / $2,137.96	Professional		$1,288.25	$1,513.56	$2,137.96