Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,801.89 / $20,892.96	Facility		$2,630.27	$3,801.89	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,778.28 / $4,677.35	Professional		$1,380.38	$1,778.28	$4,677.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $4,168.69	Professional		$1,819.70	$2,630.27	$4,168.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,090.30 / $3,801.89	Facility		$1,862.09	$3,090.30	$3,801.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $3,090.30 / $3,801.89	Professional		$1,862.09	$3,090.30	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,691.53 / $2,951.21	Facility		$2,344.23	$2,691.53	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,995.26	Facility		$1,949.84	$1,949.84	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,235.94 / $4,168.69	Professional		$1,995.26	$3,235.94	$4,168.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,818.38 / $3,801.89	Professional		$1,995.26	$2,818.38	$3,801.89
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 $1,548.82 / $2,290.87 / $3,981.07	Professional		$1,548.82	$2,290.87	$3,981.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,778.28 / $2,454.71	Professional		$1,513.56	$1,778.28	$2,454.71