Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $6,918.31 / $16,595.87	Facility		$6,918.31	$6,918.31	$16,595.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,570.88 / $5,623.41 / $9,549.93	Professional		$4,570.88	$5,623.41	$9,549.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $7,585.78 / $7,585.78	Facility		$7,585.78	$7,585.78	$7,585.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,495.41 / $5,495.41 / $7,585.78	Professional		$5,495.41	$5,495.41	$7,585.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $14,791.08 / $30,199.52	Facility		$5,888.44	$14,791.08	$30,199.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $12,589.25 / $21,877.62	Professional		$5,888.44	$12,589.25	$21,877.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $8,128.31 / $9,120.11	Professional		$75.86	$8,128.31	$9,120.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $10,471.29 / $10,715.19 / $10,964.78	Facility		$10,471.29	$10,715.19	$10,964.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $8,511.38 / $8,511.38 / $8,511.38	Professional		$8,511.38	$8,511.38	$8,511.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,332.54 / $15,848.93 / $22,908.68	Facility		$9,332.54	$15,848.93	$22,908.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,912.51 / $8,912.51 / $11,748.98	Professional		$8,912.51	$8,912.51	$11,748.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,471.29 / $10,471.29 / $10,471.29	Facility		$10,471.29	$10,471.29	$10,471.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8,912.51 / $9,332.54 / $12,022.64	Professional		$8,912.51	$9,332.54	$12,022.64
United Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $15,488.17 / $15,488.17	Facility		$4,786.30	$15,488.17	$15,488.17
United Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $6,309.57 / $8,912.51	Professional		$4,466.84	$6,309.57	$8,912.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6,606.93 / $7,585.78 / $16,218.10	Professional		$6,606.93	$7,585.78	$16,218.10