Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Facility		$3,388.44	$3,388.44	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $3,388.44	Professional		$1,000.00	$1,412.54	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $5,623.41 / $9,120.11	Facility		$2,454.71	$5,623.41	$9,120.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,659.59 / $2,290.87	Professional		$707.95	$1,659.59	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $3,311.31 / $8,511.38	Facility		$147.91	$3,311.31	$8,511.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $2,818.38 / $4,570.88	Professional		$147.91	$2,818.38	$4,570.88
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 $1,445.44 / $1,479.11 / $1,659.59	Facility		$1,445.44	$1,479.11	$1,659.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,513.56 / $1,995.26	Professional		$891.25	$1,513.56	$1,995.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $5,495.41 / $10,471.29	Facility		$4,168.69	$5,495.41	$10,471.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,412.54 / $1,905.46	Professional		$912.01	$1,412.54	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $5,754.40 / $10,232.93	Facility		$4,265.80	$5,754.40	$10,232.93
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,398.83 / $6,025.60	Professional		$1,995.26	$2,398.83	$6,025.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,238.72 / $3,162.28	Professional		$1,905.46	$2,238.72	$3,162.28