Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,344.23 / $20,892.96	Facility		$1,621.81	$2,344.23	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $2,290.87	Professional		$758.58	$977.24	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $2,630.27	Professional		$1,047.13	$1,621.81	$2,630.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,819.70 / $2,187.76	Facility		$1,071.52	$1,819.70	$2,187.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,819.70 / $2,238.72	Professional		$1,096.48	$1,819.70	$2,238.72
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 $1,230.27 / $1,659.59 / $1,778.28	Facility		$1,230.27	$1,659.59	$1,778.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,202.26	Facility		$1,174.90	$1,174.90	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,995.26 / $2,630.27	Professional		$1,202.26	$1,995.26	$2,630.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,698.24 / $2,290.87	Professional		$1,202.26	$1,698.24	$2,290.87
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 / $1,348.96 / $2,511.89	Professional		$891.25	$1,348.96	$2,511.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,174.90 / $1,659.59	Professional		$870.96	$1,174.90	$1,659.59