Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $2,089.30	Professional		$1,148.15	$1,148.15	$2,089.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Facility		$977.24	$977.24	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $831.76 / $977.24	Professional		$169.82	$831.76	$977.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility		$2,238.72	$2,238.72	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Professional		$2,238.72	$2,238.72	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $2,454.71	Professional		$199.53	$245.47	$2,454.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $3,162.28 / $3,890.45	Facility		$1,949.84	$3,162.28	$3,890.45
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,801.89 / $3,890.45	Professional		$3,162.28	$3,801.89	$3,890.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $199.53 / $1,995.26	Facility		$190.55	$199.53	$1,995.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $229.09 / $1,995.26	Professional		$190.55	$229.09	$1,995.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $186.21	Professional		$154.88	$186.21	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $891.25 / $1,513.56	Facility		$97.72	$891.25	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $954.99 / $1,621.81	Professional		$891.25	$954.99	$1,621.81