Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,548.13 / $18,620.87	Facility		$2,041.74	$3,548.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,380.38 / $3,090.30	Professional		$1,071.52	$1,380.38	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,137.96 / $3,467.37	Professional		$1,380.38	$2,137.96	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,344.23 / $2,884.03	Facility		$1,288.25	$2,344.23	$2,884.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,344.23 / $2,951.21	Professional		$1,348.96	$2,344.23	$2,951.21
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 $1,698.24 / $2,089.30 / $2,344.23	Facility		$1,698.24	$2,089.30	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,630.27 / $3,388.44	Professional		$1,584.89	$2,630.27	$3,388.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,238.72 / $3,019.95	Professional		$1,584.89	$2,238.72	$3,019.95
United Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $2,344.23	Facility		$354.81	$354.81	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,778.28 / $3,311.31	Professional		$1,096.48	$1,778.28	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $2,041.74	Professional		$1,071.52	$1,445.44	$2,041.74