Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,890.45 / $20,892.96	Facility		$2,818.38	$3,890.45	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,862.09 / $4,073.80	Professional		$1,412.54	$1,862.09	$4,073.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,162.28 / $3,801.89	Facility		$1,819.70	$3,162.28	$3,801.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,162.28 / $3,801.89	Professional		$1,819.70	$3,162.28	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,884.03 / $3,090.30	Facility		$2,290.87	$2,884.03	$3,090.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,089.30	Facility		$2,041.74	$2,041.74	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,467.37 / $4,466.84	Professional		$2,089.30	$3,467.37	$4,466.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,951.21 / $3,981.07	Professional		$2,089.30	$2,951.21	$3,981.07
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 $1,479.11 / $2,344.23 / $4,365.16	Professional		$1,479.11	$2,344.23	$4,365.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,995.26 / $2,818.38	Professional		$1,479.11	$1,995.26	$2,818.38