Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $6,309.57	Professional		$3,388.44	$3,388.44	$6,309.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,951.21	Facility		$2,884.03	$2,884.03	$2,951.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,951.21	Professional		$2,454.71	$2,454.71	$2,951.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $6,606.93	Facility		$6,606.93	$6,606.93	$6,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $6,606.93	Professional		$6,606.93	$6,606.93	$6,606.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,677.35 / $5,248.07 / $5,754.40	Professional		$4,677.35	$5,248.07	$5,754.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9,549.93 / $11,481.54 / $11,481.54	Facility		$9,549.93	$11,481.54	$11,481.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $9,549.93 / $11,481.54 / $11,481.54	Professional		$9,549.93	$11,481.54	$11,481.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $588.84 / $5,888.44	Facility		$562.34	$588.84	$5,888.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $776.25 / $5,888.44	Professional		$562.34	$776.25	$5,888.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $562.34 / $562.34	Professional		$457.09	$562.34	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,949.84 / $4,570.88	Facility		$34.67	$1,949.84	$4,570.88
United Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,884.03 / $4,786.30	Professional		$2,691.53	$2,884.03	$4,786.30