Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $9,120.11 / $21,877.62	Facility		$1,819.70	$9,120.11	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,230.27 / $3,019.95	Professional		$954.99	$1,230.27	$3,019.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,949.84 / $2,951.21	Professional		$1,202.26	$1,949.84	$2,951.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,137.96 / $2,691.53	Facility		$1,230.27	$2,137.96	$2,691.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,137.96 / $2,691.53	Professional		$1,230.27	$2,137.96	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $616.60 / $1,122.02	Professional		$75.86	$616.60	$1,122.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,905.46 / $1,949.84	Facility		$1,621.81	$1,905.46	$1,949.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,348.96	Facility		$1,288.25	$1,288.25	$1,348.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,187.76 / $2,818.38	Professional		$1,348.96	$2,187.76	$2,818.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,445.44 / $2,754.23	Facility		$1,202.26	$1,445.44	$2,754.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,905.46 / $2,754.23	Professional		$1,318.26	$1,905.46	$2,754.23
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 / $1,548.82 / $2,951.21	Professional		$1,023.29	$1,548.82	$2,951.21
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