Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,073.80 / $20,892.96	Facility		$2,818.38	$4,073.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,819.70 / $3,890.45	Professional		$1,380.38	$1,819.70	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,951.21 / $4,786.30	Professional		$1,905.46	$2,951.21	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,311.31 / $4,073.80	Facility		$1,905.46	$3,311.31	$4,073.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,311.31 / $4,073.80	Professional		$1,949.84	$3,311.31	$4,073.80
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 $2,290.87 / $3,019.95 / $3,235.94	Facility		$2,290.87	$3,019.95	$3,235.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,238.72	Facility		$2,137.96	$2,137.96	$2,238.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,715.35 / $4,786.30	Professional		$2,238.72	$3,715.35	$4,786.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,162.28 / $4,168.69	Professional		$2,187.76	$3,162.28	$4,168.69
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 $1,584.89 / $2,511.89 / $4,570.88	Professional		$1,584.89	$2,511.89	$4,570.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,089.30 / $2,951.21	Professional		$1,548.82	$2,089.30	$2,951.21