Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $15,848.93	Facility		$6,606.93	$6,606.93	$15,848.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,570.88 / $5,495.41 / $9,549.93	Professional		$4,570.88	$5,495.41	$9,549.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $7,244.36 / $7,244.36	Facility		$7,244.36	$7,244.36	$7,244.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $7,244.36	Professional		$5,248.07	$5,248.07	$7,244.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $13,803.84 / $28,840.32	Facility		$5,888.44	$13,803.84	$28,840.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $12,022.64 / $21,379.62	Professional		$5,754.40	$12,022.64	$21,379.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $7,762.47 / $8,709.64	Professional		$75.86	$7,762.47	$8,709.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $10,232.93 / $10,471.29	Facility		$10,000.00	$10,232.93	$10,471.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $8,128.31 / $8,128.31 / $8,128.31	Professional		$8,128.31	$8,128.31	$8,128.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,912.51 / $14,791.08 / $21,877.62	Facility		$8,912.51	$14,791.08	$21,877.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,511.38 / $8,511.38 / $11,220.18	Professional		$8,511.38	$8,511.38	$11,220.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $10,000.00 / $10,000.00	Facility		$10,000.00	$10,000.00	$10,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8,317.64 / $8,912.51 / $11,481.54	Professional		$8,317.64	$8,912.51	$11,481.54
United Facility/Professional Facility Modifier Low / Median / High Price $5,128.61 / $15,135.61 / $15,135.61	Facility		$5,128.61	$15,135.61	$15,135.61
United Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $6,165.95 / $8,709.64	Professional		$4,365.16	$6,165.95	$8,709.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5,623.41 / $7,244.36 / $15,488.17	Professional		$5,623.41	$7,244.36	$15,488.17