Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,760.83 / $12,302.69 / $15,488.17	Facility		$6,760.83	$12,302.69	$15,488.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,309.57 / $7,585.78	Professional		$6,165.95	$6,309.57	$7,585.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $5,888.44 / $12,882.50	Facility		$5,888.44	$5,888.44	$12,882.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $7,585.78	Professional		$6,165.95	$6,165.95	$7,585.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $6,606.93 / $12,022.64	Facility		$6,456.54	$6,606.93	$12,022.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $7,244.36 / $18,197.01	Facility		$5,495.41	$7,244.36	$18,197.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,309.57 / $6,760.83 / $7,413.10	Professional		$6,309.57	$6,760.83	$7,413.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $7,585.78 / $18,197.01	Facility		$6,165.95	$7,585.78	$18,197.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
United Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Facility		$6,165.95	$6,165.95	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $8,128.31	Professional		$6,165.95	$6,165.95	$8,128.31