Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $3,630.78	Facility		$1,513.56	$1,513.56	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,122.02 / $1,995.26	Professional		$831.76	$1,122.02	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $1,122.02	Professional		$831.76	$831.76	$1,122.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $2,754.23 / $6,606.93	Facility		$1,148.15	$2,754.23	$6,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $2,691.53 / $4,466.84	Professional		$1,148.15	$2,691.53	$4,466.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $1,778.28 / $1,949.84	Professional		$75.86	$1,778.28	$1,949.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,862.09 / $2,344.23	Facility		$1,778.28	$1,862.09	$2,344.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,344.23 / $2,344.23	Professional		$1,819.70	$2,344.23	$2,344.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,388.44 / $5,011.87	Facility		$2,041.74	$3,388.44	$5,011.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,570.40	Professional		$1,949.84	$1,949.84	$2,570.40
Regence BlueShield 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
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,041.74 / $2,630.27	Professional		$1,905.46	$2,041.74	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,951.21 / $2,951.21	Facility		$1,202.26	$2,951.21	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,202.26 / $1,737.80	Professional		$851.14	$1,202.26	$1,737.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,659.59 / $3,548.13	Professional		$1,096.48	$1,659.59	$3,548.13