Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,818.38 / $20,892.96	Facility		$1,778.28	$2,818.38	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,202.26 / $3,090.30	Professional		$954.99	$1,202.26	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,778.28 / $2,818.38	Professional		$1,174.90	$1,778.28	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $2,630.27	Facility		$1,202.26	$2,041.74	$2,630.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,041.74 / $2,630.27	Professional		$1,202.26	$2,041.74	$2,630.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,819.70 / $1,949.84	Facility		$1,584.89	$1,819.70	$1,949.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,187.76 / $2,818.38	Professional		$1,318.26	$2,187.76	$2,818.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,905.46 / $2,570.40	Professional		$1,348.96	$1,905.46	$2,570.40
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 $1,023.29 / $1,513.56 / $2,691.53	Professional		$1,023.29	$1,513.56	$2,691.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,174.90 / $1,659.59	Professional		$1,000.00	$1,174.90	$1,659.59