Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Facility		$1,148.15	$1,148.15	$1,148.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,047.13 / $1,148.15	Professional		$912.01	$1,047.13	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,047.13	Facility		$1,000.00	$1,000.00	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $602.56 / $870.96	Facility		$380.19	$602.56	$870.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $676.08 / $870.96	Professional		$588.84	$676.08	$870.96
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 $302.00 / $1,047.13 / $1,318.26	Facility		$302.00	$1,047.13	$1,318.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $1,023.29	Facility		$831.76	$831.76	$1,023.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,023.29 / $1,023.29	Professional		$1,000.00	$1,023.29	$1,023.29
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 / $1,000.00	Professional		$125.89	$151.36	$1,000.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04