Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $14,454.40	Facility		$6,025.60	$6,025.60	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $4,786.30 / $8,511.38	Professional		$3,467.37	$4,786.30	$8,511.38
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 $4,786.30 / $4,786.30 / $6,606.93	Professional		$4,786.30	$4,786.30	$6,606.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $12,022.64 / $26,915.35	Facility		$5,011.87	$12,022.64	$26,915.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,011.87 / $10,964.78 / $18,620.87	Professional		$5,011.87	$10,964.78	$18,620.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $7,079.46 / $7,943.28	Professional		$75.86	$7,079.46	$7,943.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9,120.11 / $9,332.54 / $9,772.37	Facility		$9,120.11	$9,332.54	$9,772.37
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $7,413.10 / $7,413.10 / $9,332.54	Professional		$7,413.10	$7,413.10	$9,332.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,128.31 / $13,803.84 / $19,952.62	Facility		$8,128.31	$13,803.84	$19,952.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,762.47 / $7,762.47 / $10,232.93	Professional		$7,762.47	$7,762.47	$10,232.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,120.11 / $9,120.11 / $9,120.11	Facility		$9,120.11	$9,120.11	$9,120.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $7,762.47 / $8,128.31 / $10,471.29	Professional		$7,762.47	$8,128.31	$10,471.29
United Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $13,182.57 / $13,182.57	Facility		$4,466.84	$13,182.57	$13,182.57
United Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $5,370.32 / $7,585.78	Professional		$3,801.89	$5,370.32	$7,585.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $6,606.93 / $14,454.40	Professional		$4,897.79	$6,606.93	$14,454.40