Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility		$1,548.82	$1,548.82	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,737.80	Professional		$1,380.38	$1,380.38	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,380.38	Facility		$1,318.26	$1,318.26	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,698.24	Professional		$1,380.38	$1,380.38	$1,698.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $562.34 / $2,511.89	Facility		$346.74	$562.34	$2,511.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,388.44 / $4,168.69	Professional		$2,511.89	$3,388.44	$4,168.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $75.86	Professional		$30.20	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,698.24 / $2,089.30	Facility		$1,380.38	$1,698.24	$2,089.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,041.74	Facility		$1,949.84	$1,949.84	$2,041.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,041.74 / $2,041.74	Professional		$1,949.84	$2,041.74	$2,041.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $131.83	Professional		$125.89	$125.89	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $1,949.84	Professional		$125.89	$151.36	$1,949.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04