Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $5,754.40	Professional		$3,162.28	$3,162.28	$5,754.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Facility		$3,467.37	$3,467.37	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $2,951.21 / $3,467.37	Professional		$549.54	$2,951.21	$3,467.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Facility		$6,165.95	$6,165.95	$6,165.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $4,365.16 / $5,370.32	Professional		$588.84	$4,365.16	$5,370.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $10,471.29 / $12,589.25	Facility		$6,165.95	$10,471.29	$12,589.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $10,471.29 / $12,302.69 / $12,589.25	Professional		$10,471.29	$12,302.69	$12,589.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $549.54 / $5,495.41	Facility		$524.81	$549.54	$5,495.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $724.44 / $5,495.41	Professional		$524.81	$724.44	$5,495.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $524.81 / $524.81	Professional		$426.58	$524.81	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $2,137.96 / $4,897.79	Facility		$36.31	$2,137.96	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,090.30 / $6,025.60	Professional		$2,884.03	$3,090.30	$6,025.60