Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $7,413.10	Facility		$3,162.28	$3,162.28	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,162.28 / $3,630.78	Professional		$2,290.87	$3,162.28	$3,630.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $6,760.83	Facility		$3,548.13	$3,548.13	$6,760.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Professional		$3,548.13	$3,548.13	$3,548.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $9,332.54 / $10,964.78	Facility		$4,570.88	$9,332.54	$10,964.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $9,332.54 / $12,022.64	Professional		$5,754.40	$9,332.54	$12,022.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $4,365.16	Professional		$32.36	$33.11	$4,365.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $8,317.64	Facility		$3,981.07	$3,981.07	$8,317.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Facility		$3,981.07	$3,981.07	$3,981.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Professional		$3,981.07	$3,981.07	$3,981.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Facility		$3,981.07	$3,981.07	$3,981.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Professional		$3,981.07	$3,981.07	$3,981.07
United Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Professional		$4,168.69	$4,168.69	$4,168.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $5,128.61 / $5,623.41	Professional		$3,981.07	$5,128.61	$5,623.41