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 $758.58 / $1,000.00 / $2,570.40	Professional		$758.58	$1,000.00	$2,570.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,778.28 / $2,818.38	Professional		$1,096.48	$1,778.28	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,905.46 / $2,344.23	Facility		$1,071.52	$1,905.46	$2,344.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,905.46 / $2,398.83	Professional		$1,122.02	$1,905.46	$2,398.83
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 $1,348.96 / $1,819.70 / $1,905.46	Facility		$1,348.96	$1,819.70	$1,905.46
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 / $2,754.23	Professional		$1,318.26	$2,187.76	$2,754.23
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 $891.25 / $1,479.11 / $2,691.53	Professional		$891.25	$1,479.11	$2,691.53
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