Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $5,754.40	Facility		$2,398.83	$2,398.83	$5,754.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,041.74 / $3,388.44	Professional		$1,621.81	$2,041.74	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Facility		$2,454.71	$2,454.71	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $2,454.71	Professional		$1,778.28	$1,778.28	$2,454.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $5,011.87 / $10,471.29	Facility		$2,137.96	$5,011.87	$10,471.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $4,466.84 / $7,943.28	Professional		$2,137.96	$4,466.84	$7,943.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $2,818.38 / $3,162.28	Professional		$75.86	$2,818.38	$3,162.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,715.35 / $3,890.45	Facility		$3,630.78	$3,715.35	$3,890.45
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Professional		$2,951.21	$2,951.21	$2,951.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $5,495.41 / $7,943.28	Facility		$3,235.94	$5,495.41	$7,943.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $4,073.80	Professional		$3,090.30	$3,090.30	$4,073.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility		$3,630.78	$3,630.78	$3,630.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,235.94 / $4,168.69	Professional		$3,090.30	$3,235.94	$4,168.69
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $5,495.41 / $5,495.41	Facility		$2,238.72	$5,495.41	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,290.87 / $3,235.94	Professional		$1,584.89	$2,290.87	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,630.27 / $5,623.41	Professional		$2,089.30	$2,630.27	$5,623.41