Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $5,623.41	Facility		$2,344.23	$2,344.23	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,041.74 / $3,981.07	Professional		$1,445.44	$2,041.74	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility		$2,398.83	$2,398.83	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $2,398.83	Professional		$1,737.80	$1,737.80	$2,398.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $5,011.87 / $10,232.93	Facility		$2,137.96	$5,011.87	$10,232.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $4,365.16 / $7,762.47	Professional		$2,137.96	$4,365.16	$7,762.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $2,754.23 / $3,019.95	Professional		$75.86	$2,754.23	$3,019.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,548.13 / $3,630.78	Facility		$3,311.31	$3,548.13	$3,630.78
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 $3,162.28 / $5,248.07 / $7,762.47	Facility		$3,162.28	$5,248.07	$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 $2,951.21 / $3,162.28 / $4,073.80	Professional		$2,951.21	$3,162.28	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,495.41 / $5,495.41	Facility		$1,698.24	$5,495.41	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,238.72 / $3,235.94	Professional		$1,584.89	$2,238.72	$3,235.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,570.40 / $5,495.41	Professional		$2,089.30	$2,570.40	$5,495.41