Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $7,413.10 / $10,000.00	Facility		$120.23	$7,413.10	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $5,370.32	Professional		$4,265.80	$4,265.80	$5,370.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $4,265.80 / $4,265.80	Facility		$3,981.07	$4,265.80	$4,265.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,786.30	Professional		$4,265.80	$4,265.80	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $4,265.80 / $9,772.37	Facility		$91.20	$4,265.80	$9,772.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $4,265.80 / $7,762.47	Professional		$91.20	$4,265.80	$7,762.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $4,570.88 / $5,623.41	Professional		$70.79	$4,570.88	$5,623.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,570.88 / $7,762.47	Facility		$4,168.69	$4,570.88	$7,762.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $4,466.84 / $10,471.29	Facility		$3,630.78	$4,466.84	$10,471.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $5,011.87	Professional		$4,365.16	$4,365.16	$5,011.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $4,677.35 / $11,220.18	Facility		$3,890.45	$4,677.35	$11,220.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,677.35 / $4,677.35	Professional		$4,265.80	$4,677.35	$4,677.35
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Facility		$4,265.80	$4,265.80	$4,265.80
United Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,786.30	Professional		$4,265.80	$4,265.80	$4,786.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $4,265.80 / $5,495.41	Professional		$3,981.07	$4,265.80	$5,495.41