Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,570.88 / $20,892.96	Facility		$2,818.38	$4,570.88	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,187.76 / $5,754.40	Professional		$1,698.24	$2,187.76	$5,754.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,235.94 / $5,128.61	Professional		$2,137.96	$3,235.94	$5,128.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,715.35 / $4,570.88	Facility		$2,187.76	$3,715.35	$4,570.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,715.35 / $4,570.88	Professional		$2,187.76	$3,715.35	$4,570.88
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 $2,884.03 / $3,311.31 / $3,548.13	Facility		$2,884.03	$3,311.31	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility		$2,398.83	$2,398.83	$2,398.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,981.07 / $5,128.61	Professional		$2,398.83	$3,981.07	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,467.37 / $4,677.35	Professional		$2,454.71	$3,467.37	$4,677.35
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 $1,905.46 / $2,818.38 / $4,897.79	Professional		$1,905.46	$2,818.38	$4,897.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,137.96 / $3,019.95	Professional		$1,819.70	$2,137.96	$3,019.95