Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $5,754.40 / $12,589.25	Facility		$1,174.90	$5,754.40	$12,589.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,000.00 / $1,513.56	Professional		$758.58	$1,000.00	$1,513.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,818.38 / $3,235.94	Facility		$1,318.26	$2,818.38	$3,235.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,258.93 / $5,888.44	Facility		$1,148.15	$1,258.93	$5,888.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,258.93 / $2,137.96	Professional		$1,000.00	$1,258.93	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,778.28	Facility		$1,258.93	$1,258.93	$1,778.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,187.76 / $3,801.89	Facility		$1,258.93	$2,187.76	$3,801.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,513.56	Professional		$1,148.15	$1,148.15	$1,513.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,905.46 / $3,467.37	Facility		$1,318.26	$1,905.46	$3,467.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,148.15 / $1,412.54	Professional		$1,071.52	$1,148.15	$1,412.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,513.56 / $1,513.56	Facility		$1,258.93	$1,513.56	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $1,412.54	Professional		$524.81	$524.81	$1,412.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,258.93 / $2,290.87	Professional		$562.34	$1,258.93	$2,290.87