Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $8,912.51	Facility		$3,801.89	$3,801.89	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,090.30 / $4,897.79	Professional		$2,344.23	$3,090.30	$4,897.79
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 $2,691.53 / $2,691.53 / $3,715.35	Professional		$2,691.53	$2,691.53	$3,715.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $9,549.93 / $17,782.79	Facility		$5,370.32	$9,549.93	$17,782.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $8,128.31 / $13,182.57	Professional		$4,897.79	$8,128.31	$13,182.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $4,466.84 / $4,897.79	Professional		$75.86	$4,466.84	$4,897.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $5,888.44 / $6,165.95	Facility		$5,623.41	$5,888.44	$6,165.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Professional		$4,677.35	$4,677.35	$4,677.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,128.61 / $8,511.38 / $12,589.25	Facility		$5,128.61	$8,511.38	$12,589.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $6,309.57	Professional		$4,786.30	$4,786.30	$6,309.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Facility		$5,623.41	$5,623.41	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $5,011.87 / $6,606.93	Professional		$4,786.30	$5,011.87	$6,606.93
United Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $8,317.64 / $8,317.64	Facility		$3,388.44	$8,317.64	$8,317.64
United Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,548.13 / $4,897.79	Professional		$2,398.83	$3,548.13	$4,897.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $5,011.87 / $8,912.51	Professional		$4,168.69	$5,011.87	$8,912.51