Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,248.07 / $20,892.96	Facility		$2,818.38	$5,248.07	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,691.53 / $5,495.41	Professional		$1,412.54	$2,691.53	$5,495.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,890.45 / $6,165.95	Professional		$2,511.89	$3,890.45	$6,165.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,570.88 / $5,623.41	Facility		$2,570.40	$4,570.88	$5,623.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $4,570.88 / $5,623.41	Professional		$2,570.40	$4,570.88	$5,623.41
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 $2,570.40 / $4,073.80 / $4,265.80	Facility		$2,570.40	$4,073.80	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility		$2,884.03	$2,884.03	$2,884.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,786.30 / $6,165.95	Professional		$2,884.03	$4,786.30	$6,165.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $4,168.69 / $5,623.41	Professional		$2,951.21	$4,168.69	$5,623.41
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 $1,949.84 / $2,951.21 / $5,888.44	Professional		$1,949.84	$2,951.21	$5,888.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,570.40 / $3,630.78	Professional		$2,238.72	$2,570.40	$3,630.78