Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,265.80 / $20,892.96	Facility		$2,570.40	$4,265.80	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,905.46 / $4,073.80	Professional		$1,412.54	$1,905.46	$4,073.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,162.28 / $5,011.87	Professional		$1,995.26	$3,162.28	$5,011.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,388.44 / $4,265.80	Facility		$1,584.89	$3,388.44	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $3,388.44 / $4,265.80	Professional		$1,698.24	$3,388.44	$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 $2,137.96 / $3,019.95 / $3,467.37	Facility		$2,137.96	$3,019.95	$3,467.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,344.23	Facility		$2,290.87	$2,290.87	$2,344.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,890.45 / $5,011.87	Professional		$2,344.23	$3,890.45	$5,011.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,311.31 / $4,466.84	Professional		$2,344.23	$3,311.31	$4,466.84
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 $1,698.24 / $2,511.89 / $4,897.79	Professional		$1,698.24	$2,511.89	$4,897.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,238.72 / $3,162.28	Professional		$1,659.59	$2,238.72	$3,162.28