Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,584.89	Professional		$1,412.54	$1,412.54	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,412.54	Facility		$1,348.96	$1,348.96	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,737.80	Professional		$1,412.54	$1,412.54	$1,737.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $562.34 / $2,187.76	Facility		$346.74	$562.34	$2,187.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,754.23 / $3,630.78	Professional		$2,187.76	$2,754.23	$3,630.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $60.26	Professional		$30.20	$30.20	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,412.54 / $2,137.96	Facility		$1,380.38	$1,412.54	$2,137.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility		$1,445.44	$1,445.44	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,584.89	Professional		$1,445.44	$1,445.44	$1,584.89
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 / $1,445.44	Professional		$125.89	$151.36	$1,445.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04