Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $8,912.51 / $9,120.11	Facility		$3,801.89	$8,912.51	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,630.78 / $3,715.35 / $4,466.84	Professional		$3,630.78	$3,715.35	$4,466.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $7,585.78	Facility		$3,801.89	$3,801.89	$7,585.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Professional		$3,801.89	$3,801.89	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,047.13 / $19,054.61	Facility		$630.96	$1,047.13	$19,054.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $912.01 / $1,230.27	Professional		$630.96	$912.01	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $4,677.35	Professional		$32.36	$33.11	$4,677.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $7,413.10	Facility		$3,019.95	$3,019.95	$7,413.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,786.30 / $11,748.98	Facility		$3,715.35	$4,786.30	$11,748.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Professional		$4,265.80	$4,265.80	$4,265.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $5,011.87 / $12,022.64	Facility		$4,168.69	$5,011.87	$12,022.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Professional		$4,265.80	$4,265.80	$4,265.80
United Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Facility		$4,168.69	$4,168.69	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $4,466.84	Professional		$3,715.35	$3,715.35	$4,466.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $5,495.41 / $6,025.60	Professional		$4,265.80	$5,495.41	$6,025.60