Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $2,630.27	Facility		$1,096.48	$1,096.48	$2,630.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $891.25 / $1,513.56	Professional		$645.65	$891.25	$1,513.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $1,230.27	Professional		$891.25	$891.25	$1,230.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $2,187.76 / $4,786.30	Facility		$933.25	$2,187.76	$4,786.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,995.26 / $3,467.37	Professional		$933.25	$1,995.26	$3,467.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $1,174.90 / $1,412.54	Professional		$75.86	$1,174.90	$1,412.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,659.59 / $1,698.24	Facility		$1,348.96	$1,659.59	$1,698.24
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,698.24 / $1,698.24	Professional		$1,513.56	$1,698.24	$1,698.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,454.71 / $3,630.78	Facility		$1,479.11	$2,454.71	$3,630.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,862.09	Professional		$1,412.54	$1,412.54	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $1,905.46	Professional		$1,380.38	$1,479.11	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $2,398.83 / $2,398.83	Facility		$977.24	$2,398.83	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,000.00 / $1,412.54	Professional		$691.83	$1,000.00	$1,412.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,479.11 / $2,570.40	Professional		$1,202.26	$1,479.11	$2,570.40