Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,995.26 / $20,892.96	Facility		$1,318.26	$1,995.26	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $870.96 / $1,995.26	Professional		$660.69	$870.96	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,318.26 / $2,089.30	Professional		$831.76	$1,318.26	$2,089.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,445.44 / $1,778.28	Facility		$851.14	$1,445.44	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,479.11 / $1,778.28	Professional		$870.96	$1,479.11	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,348.96 / $1,412.54	Facility		$1,148.15	$1,348.96	$1,412.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $977.24	Facility		$954.99	$954.99	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,584.89 / $2,041.74	Professional		$954.99	$1,584.89	$2,041.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,348.96 / $1,819.70	Professional		$1,000.00	$1,348.96	$1,819.70
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 $707.95 / $1,148.15 / $1,995.26	Professional		$707.95	$1,148.15	$1,995.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $870.96 / $1,230.27	Professional		$645.65	$870.96	$1,230.27