Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,265.80 / $20,892.96	Facility		$2,818.38	$4,265.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,041.74 / $4,265.80	Professional		$1,479.11	$2,041.74	$4,265.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,951.21 / $4,786.30	Professional		$1,949.84	$2,951.21	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,235.94 / $4,073.80	Facility		$1,995.26	$3,235.94	$4,073.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,388.44 / $4,073.80	Professional		$1,995.26	$3,388.44	$4,073.80
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 $2,630.27 / $3,090.30 / $3,235.94	Facility		$2,630.27	$3,090.30	$3,235.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,187.76	Facility		$2,137.96	$2,137.96	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,630.78 / $4,677.35	Professional		$2,187.76	$3,630.78	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,090.30 / $4,073.80	Professional		$2,187.76	$3,090.30	$4,073.80
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 $1,621.81 / $2,630.27 / $4,570.88	Professional		$1,621.81	$2,630.27	$4,570.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,949.84 / $2,691.53	Professional		$1,445.44	$1,949.84	$2,691.53