Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,677.35 / $27,542.29	Facility		$2,818.38	$4,677.35	$27,542.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,187.76 / $4,897.79	Professional		$1,698.24	$2,187.76	$4,897.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,311.31 / $5,370.32	Professional		$2,137.96	$3,311.31	$5,370.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,630.78 / $4,570.88	Facility		$2,187.76	$3,630.78	$4,570.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,801.89 / $4,570.88	Professional		$2,238.72	$3,801.89	$4,570.88
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 $2,951.21 / $3,467.37 / $3,548.13	Facility		$2,951.21	$3,467.37	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,454.71	Facility		$2,398.83	$2,398.83	$2,454.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,981.07 / $5,248.07	Professional		$2,454.71	$3,981.07	$5,248.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,388.44 / $4,570.88	Professional		$2,398.83	$3,388.44	$4,570.88
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 $1,819.70 / $2,884.03 / $5,128.61	Professional		$1,819.70	$2,884.03	$5,128.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,137.96 / $3,019.95	Professional		$1,584.89	$2,137.96	$3,019.95