Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,584.89 / $2,884.03	Professional		$1,548.82	$1,584.89	$2,884.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility		$1,862.09	$1,862.09	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $1,584.89 / $1,862.09	Professional		$269.15	$1,584.89	$1,862.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Facility		$3,090.30	$3,090.30	$3,090.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Professional		$3,090.30	$3,090.30	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,398.83 / $2,630.27	Professional		$1,949.84	$2,398.83	$2,630.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,128.61 / $6,309.57	Facility		$3,090.30	$5,128.61	$6,309.57
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,128.61 / $6,165.95 / $6,309.57	Professional		$5,128.61	$6,165.95	$6,309.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $275.42 / $2,754.23	Facility		$263.03	$275.42	$2,754.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $363.08 / $2,754.23	Professional		$263.03	$363.08	$2,754.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $257.04	Professional		$213.80	$257.04	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $1,071.52 / $2,454.71	Facility		$27.54	$1,071.52	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,862.09 / $3,019.95	Professional		$1,548.82	$1,862.09	$3,019.95