Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $7,413.10	Facility		$3,162.28	$3,162.28	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,691.53 / $4,365.16	Professional		$1,995.26	$2,691.53	$4,365.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility		$2,754.23	$2,754.23	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,754.23	Professional		$2,041.74	$2,041.74	$2,754.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $6,606.93 / $13,803.84	Facility		$2,818.38	$6,606.93	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $5,754.40 / $10,232.93	Professional		$2,818.38	$5,754.40	$10,232.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $3,715.35 / $4,073.80	Professional		$75.86	$3,715.35	$4,073.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,897.79 / $5,888.44	Facility		$4,786.30	$4,897.79	$5,888.44
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Professional		$3,890.45	$3,890.45	$3,890.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $7,079.46 / $10,471.29	Facility		$4,265.80	$7,079.46	$10,471.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $5,370.32	Professional		$4,073.80	$4,073.80	$5,370.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $5,495.41	Professional		$4,265.80	$4,265.80	$5,495.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $7,244.36 / $7,244.36	Facility		$2,511.89	$7,244.36	$7,244.36
United Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,951.21 / $4,265.80	Professional		$2,089.30	$2,951.21	$4,265.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,265.80 / $7,413.10	Professional		$3,467.37	$4,265.80	$7,413.10