Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $7,762.47 / $20,892.96	Facility		$1,737.80	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,122.02 / $2,630.27	Professional		$870.96	$1,122.02	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,737.80 / $2,754.23	Professional		$1,096.48	$1,737.80	$2,754.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,905.46 / $2,344.23	Facility		$1,122.02	$1,905.46	$2,344.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,949.84 / $2,344.23	Professional		$1,148.15	$1,949.84	$2,344.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,778.28 / $1,862.09	Facility		$1,479.11	$1,778.28	$1,862.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,258.93 / $1,258.93	Facility		$1,230.27	$1,258.93	$1,258.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,089.30 / $2,691.53	Professional		$1,258.93	$2,089.30	$2,691.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,778.28 / $2,344.23	Professional		$1,258.93	$1,778.28	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $5,495.41	Facility		$1,445.44	$1,445.44	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,479.11 / $2,630.27	Professional		$933.25	$1,479.11	$2,630.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,122.02 / $1,584.89	Professional		$831.76	$1,122.02	$1,584.89