Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,168.69 / $20,892.96	Facility		$2,818.38	$4,168.69	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,862.09 / $4,365.16	Professional		$1,445.44	$1,862.09	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,090.30 / $4,897.79	Professional		$1,995.26	$3,090.30	$4,897.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,388.44 / $4,168.69	Facility		$1,995.26	$3,388.44	$4,168.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,467.37 / $4,265.80	Professional		$2,041.74	$3,467.37	$4,265.80
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 $2,344.23 / $3,162.28 / $3,388.44	Facility		$2,344.23	$3,162.28	$3,388.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,290.87	Facility		$2,238.72	$2,238.72	$2,290.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,801.89 / $4,897.79	Professional		$2,290.87	$3,801.89	$4,897.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,235.94 / $4,365.16	Professional		$2,290.87	$3,235.94	$4,365.16
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 / $4,786.30	Professional		$1,621.81	$2,630.27	$4,786.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,137.96 / $3,019.95	Professional		$1,584.89	$2,137.96	$3,019.95