Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,897.79 / $20,892.96	Facility		$2,818.38	$4,897.79	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,238.72 / $5,128.61	Professional		$1,698.24	$2,238.72	$5,128.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,630.78 / $5,754.40	Professional		$2,344.23	$3,630.78	$5,754.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,981.07 / $4,897.79	Facility		$1,995.26	$3,981.07	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,981.07 / $5,011.87	Professional		$2,089.30	$3,981.07	$5,011.87
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 $2,951.21 / $3,715.35 / $3,981.07	Facility		$2,951.21	$3,715.35	$3,981.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,754.23	Facility		$2,630.27	$2,630.27	$2,754.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,466.84 / $5,888.44	Professional		$2,754.23	$4,466.84	$5,888.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,801.89 / $5,128.61	Professional		$2,691.53	$3,801.89	$5,128.61
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 $1,905.46 / $3,090.30 / $5,623.41	Professional		$1,905.46	$3,090.30	$5,623.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,511.89 / $3,548.13	Professional		$1,862.09	$2,511.89	$3,548.13