Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16,595.87 / $16,595.87 / $39,810.72	Facility		$16,595.87	$16,595.87	$39,810.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15,488.17 / $16,218.10 / $16,982.44	Professional		$15,488.17	$16,218.10	$16,982.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16,595.87 / $16,595.87 / $33,113.11	Facility		$16,595.87	$16,595.87	$33,113.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16,595.87 / $16,595.87 / $16,595.87	Professional		$16,595.87	$16,595.87	$16,595.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,772.37 / $79,432.82	Facility		$5,888.44	$9,772.37	$79,432.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $8,709.64 / $11,481.54	Professional		$5,888.44	$8,709.64	$11,481.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $75.86	Professional		$50.12	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $7,762.47	Facility		$3,090.30	$3,090.30	$7,762.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $17,378.01 / $47,863.01	Facility		$3,890.45	$17,378.01	$47,863.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $18,620.87 / $18,620.87 / $18,620.87	Professional		$18,620.87	$18,620.87	$18,620.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $17,378.01 / $20,892.96 / $50,118.72	Facility		$17,378.01	$20,892.96	$50,118.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $18,620.87 / $18,620.87 / $18,620.87	Professional		$18,620.87	$18,620.87	$18,620.87
United Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Facility		$3,162.28	$3,162.28	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $16,218.10 / $16,218.10 / $19,498.45	Professional		$16,218.10	$16,218.10	$19,498.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18,620.87 / $23,988.33 / $26,302.68	Professional		$18,620.87	$23,988.33	$26,302.68