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 / $5,623.41	Facility		$2,398.83	$2,398.83	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,995.26 / $3,311.31	Professional		$1,621.81	$1,995.26	$3,311.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility		$2,290.87	$2,290.87	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $2,290.87	Professional		$1,659.59	$1,659.59	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $5,011.87 / $10,471.29	Facility		$2,089.30	$5,011.87	$10,471.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $4,365.16 / $7,762.47	Professional		$2,089.30	$4,365.16	$7,762.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $2,818.38 / $3,090.30	Professional		$75.86	$2,818.38	$3,090.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,630.78 / $3,801.89	Facility		$3,548.13	$3,630.78	$3,801.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Professional		$2,884.03	$2,884.03	$2,884.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $5,370.32 / $7,762.47	Facility		$3,235.94	$5,370.32	$7,762.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,981.07	Professional		$3,019.95	$3,019.95	$3,981.07
Regence BlueShield 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
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,162.28 / $4,073.80	Professional		$3,019.95	$3,162.28	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $5,495.41 / $5,495.41	Facility		$2,187.76	$5,495.41	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,238.72 / $3,162.28	Professional		$1,584.89	$2,238.72	$3,162.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,630.27 / $5,623.41	Professional		$2,238.72	$2,630.27	$5,623.41