Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $9,772.37	Facility		$4,168.69	$4,168.69	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,162.28 / $5,754.40	Professional		$2,238.72	$3,162.28	$5,754.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $3,715.35	Facility		$3,715.35	$3,715.35	$3,715.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $3,715.35	Professional		$2,754.23	$2,754.23	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $7,762.47 / $18,197.01	Facility		$3,311.31	$7,762.47	$18,197.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $7,413.10 / $12,589.25	Professional		$3,311.31	$7,413.10	$12,589.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $4,897.79 / $5,370.32	Professional		$75.86	$4,897.79	$5,370.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $6,165.95 / $6,309.57	Facility		$5,011.87	$6,165.95	$6,309.57
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $6,309.57 / $6,309.57	Professional		$5,754.40	$6,309.57	$6,309.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $9,332.54 / $13,803.84	Facility		$5,623.41	$9,332.54	$13,803.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $7,413.10	Professional		$5,248.07	$5,248.07	$7,413.10
Regence BlueShield 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
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,495.41 / $7,079.46	Professional		$5,248.07	$5,495.41	$7,079.46
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $8,511.38 / $8,511.38	Facility		$3,467.37	$8,511.38	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,467.37 / $5,011.87	Professional		$2,454.71	$3,467.37	$5,011.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,570.88 / $5,495.41 / $9,772.37	Professional		$4,570.88	$5,495.41	$9,772.37