Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,162.28 / $20,892.96	Facility		$2,290.87	$3,162.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,513.56 / $3,548.13	Professional		$1,148.15	$1,513.56	$3,548.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,290.87 / $3,630.78	Professional		$1,479.11	$2,290.87	$3,630.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,511.89 / $3,090.30	Facility		$1,513.56	$2,511.89	$3,090.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,570.40 / $3,162.28	Professional		$1,513.56	$2,570.40	$3,162.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,398.83 / $2,454.71	Facility		$1,995.26	$2,398.83	$2,454.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,659.59	Facility		$1,621.81	$1,621.81	$1,659.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $3,548.13	Professional		$1,659.59	$2,754.23	$3,548.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,344.23 / $3,162.28	Professional		$1,659.59	$2,344.23	$3,162.28
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 $1,230.27 / $1,995.26 / $3,467.37	Professional		$1,230.27	$1,995.26	$3,467.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,479.11 / $2,089.30	Professional		$1,096.48	$1,479.11	$2,089.30