Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,466.84 / $20,892.96	Facility		$2,818.38	$4,466.84	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,089.30 / $5,248.07	Professional		$1,621.81	$2,089.30	$5,248.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,019.95 / $4,786.30	Professional		$1,995.26	$3,019.95	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,467.37 / $4,466.84	Facility		$2,041.74	$3,467.37	$4,466.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,467.37 / $4,466.84	Professional		$2,041.74	$3,467.37	$4,466.84
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 $2,691.53 / $3,090.30 / $3,467.37	Facility		$2,691.53	$3,090.30	$3,467.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility		$2,238.72	$2,238.72	$2,238.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,715.35 / $4,786.30	Professional		$2,238.72	$3,715.35	$4,786.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,235.94 / $4,365.16	Professional		$2,290.87	$3,235.94	$4,365.16
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 $1,862.09 / $2,630.27 / $4,570.88	Professional		$1,862.09	$2,630.27	$4,570.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,995.26 / $2,818.38	Professional		$1,698.24	$1,995.26	$2,818.38