Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,677.35 / $20,892.96	Facility		$2,818.38	$4,677.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,187.76 / $5,370.32	Professional		$1,698.24	$2,187.76	$5,370.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,548.13 / $5,623.41	Professional		$2,290.87	$3,548.13	$5,623.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,890.45 / $4,786.30	Facility		$2,290.87	$3,890.45	$4,786.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,981.07 / $4,786.30	Professional		$2,344.23	$3,981.07	$4,786.30
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 $3,090.30 / $3,630.78 / $3,890.45	Facility		$3,090.30	$3,630.78	$3,890.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,630.27	Facility		$2,570.40	$2,570.40	$2,630.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $4,365.16 / $5,623.41	Professional		$2,630.27	$4,365.16	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,715.35 / $4,897.79	Professional		$2,570.40	$3,715.35	$4,897.79
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 $1,862.09 / $3,019.95 / $5,370.32	Professional		$1,862.09	$3,019.95	$5,370.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,454.71 / $3,467.37	Professional		$1,819.70	$2,454.71	$3,467.37