Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $3,235.94	Facility		$1,380.38	$1,380.38	$3,235.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,148.15 / $1,905.46	Professional		$933.25	$1,148.15	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $1,202.26	Professional		$891.25	$891.25	$1,202.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,884.03 / $6,025.60	Facility		$1,230.27	$2,884.03	$6,025.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,511.89 / $4,466.84	Professional		$1,230.27	$2,511.89	$4,466.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $2,089.30 / $2,137.96	Professional		$60.26	$2,089.30	$2,137.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,041.74 / $2,187.76	Facility		$1,659.59	$2,041.74	$2,187.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,089.30 / $2,187.76	Professional		$1,905.46	$2,089.30	$2,187.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,090.30 / $4,570.88	Facility		$1,862.09	$3,090.30	$4,570.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $2,290.87	Professional		$1,737.80	$1,737.80	$2,290.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility		$2,041.74	$2,041.74	$2,041.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,819.70 / $2,344.23	Professional		$1,737.80	$1,819.70	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $3,162.28 / $3,162.28	Facility		$1,288.25	$3,162.28	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,288.25 / $1,819.70	Professional		$912.01	$1,288.25	$1,819.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,819.70 / $3,235.94	Professional		$1,513.56	$1,819.70	$3,235.94