Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,888.44 / $20,892.96	Facility		$2,951.21	$5,888.44	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,691.53 / $5,888.44	Professional		$2,041.74	$2,691.53	$5,888.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $4,466.84 / $7,079.46	Professional		$2,884.03	$4,466.84	$7,079.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $4,786.30 / $6,025.60	Facility		$2,290.87	$4,786.30	$6,025.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $4,897.79 / $6,025.60	Professional		$2,454.71	$4,897.79	$6,025.60
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 $3,311.31 / $4,466.84 / $4,897.79	Facility		$3,311.31	$4,466.84	$4,897.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,235.94 / $3,311.31	Facility		$3,235.94	$3,235.94	$3,311.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $5,495.41 / $7,079.46	Professional		$3,311.31	$5,495.41	$7,079.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,677.35 / $6,309.57	Professional		$3,311.31	$4,677.35	$6,309.57
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 $2,344.23 / $3,715.35 / $6,918.31	Professional		$2,344.23	$3,715.35	$6,918.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,090.30 / $4,365.16	Professional		$2,290.87	$3,090.30	$4,365.16