Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,890.45 / $20,892.96	Facility		$2,818.38	$3,890.45	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,778.28 / $4,168.69	Professional		$1,380.38	$1,778.28	$4,168.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,884.03 / $4,677.35	Professional		$1,862.09	$2,884.03	$4,677.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,235.94 / $3,981.07	Facility		$1,905.46	$3,235.94	$3,981.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,311.31 / $3,981.07	Professional		$1,949.84	$3,311.31	$3,981.07
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 / $2,951.21 / $3,162.28	Facility		$2,290.87	$2,951.21	$3,162.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,187.76	Facility		$2,089.30	$2,089.30	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,630.78 / $4,677.35	Professional		$2,187.76	$3,630.78	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,090.30 / $4,073.80	Professional		$2,137.96	$3,090.30	$4,073.80
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 $1,548.82 / $2,511.89 / $4,466.84	Professional		$1,548.82	$2,511.89	$4,466.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,995.26 / $2,818.38	Professional		$1,479.11	$1,995.26	$2,818.38