Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $6,456.54 / $15,488.17	Facility		$6,456.54	$6,456.54	$15,488.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $5,495.41 / $9,120.11	Professional		$4,466.84	$5,495.41	$9,120.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $6,606.93	Facility		$6,606.93	$6,606.93	$6,606.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $6,606.93	Professional		$4,897.79	$4,897.79	$6,606.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $14,454.40 / $28,840.32	Facility		$5,754.40	$14,454.40	$28,840.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $12,882.50 / $21,379.62	Professional		$5,754.40	$12,882.50	$21,379.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $7,762.47 / $8,511.38	Professional		$75.86	$7,762.47	$8,511.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9,772.37 / $10,000.00 / $10,471.29	Facility		$9,772.37	$10,000.00	$10,471.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Professional		$7,943.28	$7,943.28	$7,943.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,709.64 / $14,791.08 / $21,379.62	Facility		$8,709.64	$14,791.08	$21,379.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,317.64 / $8,317.64 / $10,964.78	Professional		$8,317.64	$8,317.64	$10,964.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,772.37 / $9,772.37 / $9,772.37	Facility		$9,772.37	$9,772.37	$9,772.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8,317.64 / $8,709.64 / $11,220.18	Professional		$8,317.64	$8,709.64	$11,220.18
United Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $15,135.61 / $15,135.61	Facility		$6,025.60	$15,135.61	$15,135.61
United Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $6,309.57 / $8,709.64	Professional		$4,365.16	$6,309.57	$8,709.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $7,244.36 / $8,709.64 / $15,488.17	Professional		$7,244.36	$8,709.64	$15,488.17