Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,754.23 / $20,892.96	Facility		$1,778.28	$2,754.23	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,174.90 / $2,818.38	Professional		$891.25	$1,174.90	$2,818.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $2,818.38	Professional		$1,148.15	$1,778.28	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,949.84 / $2,398.83	Facility		$1,174.90	$1,949.84	$2,398.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,995.26 / $2,398.83	Professional		$1,174.90	$1,995.26	$2,398.83
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 $1,548.82 / $1,862.09 / $1,905.46	Facility		$1,548.82	$1,862.09	$1,905.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,137.96 / $2,754.23	Professional		$1,288.25	$2,137.96	$2,754.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,819.70 / $2,454.71	Professional		$1,288.25	$1,819.70	$2,454.71
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,454.71 / $37,153.52	Facility		$707.95	$2,454.71	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,513.56 / $2,754.23	Professional		$954.99	$1,513.56	$2,754.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,148.15 / $1,621.81	Professional		$851.14	$1,148.15	$1,621.81