Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $2,570.40	Facility		$1,096.48	$1,096.48	$2,570.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $933.25 / $1,513.56	Professional		$660.69	$933.25	$1,513.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,258.93	Professional		$912.01	$912.01	$1,258.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $2,454.71 / $4,786.30	Facility		$977.24	$2,454.71	$4,786.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $2,137.96 / $3,548.13	Professional		$977.24	$2,137.96	$3,548.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $1,288.25 / $1,412.54	Professional		$75.86	$1,288.25	$1,412.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,698.24	Facility		$1,659.59	$1,659.59	$1,698.24
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,454.71 / $3,630.78	Facility		$1,479.11	$2,454.71	$3,630.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,949.84	Professional		$1,412.54	$1,412.54	$1,949.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $1,905.46	Professional		$1,380.38	$1,479.11	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $2,511.89 / $2,511.89	Facility		$1,023.29	$2,511.89	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,071.52 / $1,479.11	Professional		$724.44	$1,071.52	$1,479.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,202.26 / $2,570.40	Professional		$933.25	$1,202.26	$2,570.40