Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $3,235.94	Facility		$1,348.96	$1,348.96	$3,235.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,202.26 / $1,905.46	Professional		$891.25	$1,202.26	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $1,318.26	Professional		$954.99	$954.99	$1,318.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $3,162.28 / $5,754.40	Facility		$1,318.26	$3,162.28	$5,754.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,630.27 / $4,897.79	Professional		$1,318.26	$2,630.27	$4,897.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $1,548.82 / $1,698.24	Professional		$75.86	$1,548.82	$1,698.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,949.84 / $2,398.83	Facility		$1,584.89	$1,949.84	$2,398.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,995.26 / $2,398.83	Professional		$1,819.70	$1,995.26	$2,398.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,951.21 / $4,265.80	Facility		$1,737.80	$2,951.21	$4,265.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $2,290.87	Professional		$1,659.59	$1,659.59	$2,290.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility		$1,949.84	$1,949.84	$1,949.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,737.80 / $2,238.72	Professional		$1,698.24	$1,737.80	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $3,235.94 / $3,235.94	Facility		$1,000.00	$3,235.94	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,071.52 / $1,905.46	Professional		$933.25	$1,071.52	$1,905.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,737.80 / $3,090.30	Professional		$1,445.44	$1,737.80	$3,090.30