Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,290.87 / $4,265.80	Professional		$2,238.72	$2,290.87	$4,265.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,238.72	Facility		$2,187.76	$2,187.76	$2,238.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $2,238.72	Professional		$1,862.09	$1,862.09	$2,238.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Facility		$4,365.16	$4,365.16	$4,365.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Professional		$4,365.16	$4,365.16	$4,365.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $3,388.44 / $4,073.80	Professional		$446.68	$3,388.44	$4,073.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $5,495.41 / $6,760.83	Facility		$4,786.30	$5,495.41	$6,760.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,495.41 / $6,760.83 / $6,760.83	Professional		$5,495.41	$6,760.83	$6,760.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $398.11 / $3,981.07	Facility		$371.54	$398.11	$3,981.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $3,981.07	Professional		$371.54	$524.81	$3,981.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $398.11 / $398.11	Professional		$331.13	$398.11	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $1,548.82 / $3,630.78	Facility		$25.70	$1,548.82	$3,630.78
United Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $4,365.16	Professional		$2,238.72	$2,238.72	$4,365.16