Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,630.27 / $20,892.96	Facility		$1,778.28	$2,630.27	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,096.48 / $2,630.27	Professional		$831.76	$1,096.48	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,778.28 / $2,884.03	Professional		$1,096.48	$1,778.28	$2,884.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,949.84 / $2,454.71	Facility		$1,148.15	$1,949.84	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,949.84 / $2,454.71	Professional		$1,202.26	$1,949.84	$2,454.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,819.70 / $1,949.84	Facility		$1,513.56	$1,819.70	$1,949.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,318.26	Facility		$1,288.25	$1,288.25	$1,318.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,187.76 / $2,818.38	Professional		$1,318.26	$2,187.76	$2,818.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $2,454.71	Professional		$1,318.26	$1,862.09	$2,454.71
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 $933.25 / $1,513.56 / $2,754.23	Professional		$933.25	$1,513.56	$2,754.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,122.02 / $1,584.89	Professional		$831.76	$1,122.02	$1,584.89