Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,348.96 / $1,380.38	Professional		$1,288.25	$1,348.96	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $2,754.23	Facility		$1,380.38	$1,380.38	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $1,949.84 / $3,235.94	Facility		$380.19	$1,949.84	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,630.27 / $3,311.31	Professional		$2,290.87	$2,630.27	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $60.26	Professional		$30.20	$44.67	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,344.23 / $2,344.23	Facility		$1,905.46	$2,344.23	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,380.38	Facility		$1,348.96	$1,348.96	$1,380.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $1,905.46 / $3,019.95	Professional		$263.03	$1,905.46	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $1,348.96	Professional		$125.89	$151.36	$1,348.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04