Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $3,311.31	Facility		$1,412.54	$1,412.54	$3,311.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,122.02 / $2,041.74	Professional		$851.14	$1,122.02	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,584.89	Professional		$1,148.15	$1,148.15	$1,584.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,818.38 / $6,165.95	Facility		$1,174.90	$2,818.38	$6,165.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $2,511.89 / $4,365.16	Professional		$1,174.90	$2,511.89	$4,365.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $1,659.59 / $1,819.70	Professional		$75.86	$1,659.59	$1,819.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,089.30 / $2,238.72	Facility		$1,698.24	$2,089.30	$2,238.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,137.96 / $2,238.72	Professional		$1,949.84	$2,137.96	$2,238.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,162.28 / $4,677.35	Facility		$1,905.46	$3,162.28	$4,677.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $2,344.23	Professional		$1,778.28	$1,778.28	$2,344.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,862.09 / $2,398.83	Professional		$1,778.28	$1,862.09	$2,398.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $3,090.30 / $3,090.30	Facility		$1,071.52	$3,090.30	$3,090.30
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,258.93 / $1,778.28	Professional		$891.25	$1,258.93	$1,778.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $3,311.31	Professional		$1,148.15	$1,548.82	$3,311.31