Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $8,709.64	Facility		$3,715.35	$3,715.35	$8,709.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,754.23 / $4,786.30	Professional		$1,995.26	$2,754.23	$4,786.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Facility		$3,548.13	$3,548.13	$3,548.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $3,548.13	Professional		$2,570.40	$2,570.40	$3,548.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $6,760.83 / $16,218.10	Facility		$2,884.03	$6,760.83	$16,218.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $6,760.83 / $11,220.18	Professional		$2,884.03	$6,760.83	$11,220.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $4,365.16 / $4,786.30	Professional		$75.86	$4,365.16	$4,786.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $5,623.41 / $6,025.60	Facility		$4,570.88	$5,623.41	$6,025.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,128.61 / $5,754.40 / $6,025.60	Professional		$5,128.61	$5,754.40	$6,025.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,317.64 / $12,302.69	Facility		$5,011.87	$8,317.64	$12,302.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $6,606.93	Professional		$4,786.30	$4,786.30	$6,606.93
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 $4,677.35 / $4,897.79 / $6,456.54	Professional		$4,677.35	$4,897.79	$6,456.54
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $7,413.10 / $7,413.10	Facility		$3,019.95	$7,413.10	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,090.30 / $4,365.16	Professional		$2,137.96	$3,090.30	$4,365.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $4,073.80 / $8,709.64	Professional		$2,818.38	$4,073.80	$8,709.64