Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9,332.54 / $9,332.54 / $21,877.62	Facility		$9,332.54	$9,332.54	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $8,511.38 / $13,803.84	Professional		$6,165.95	$8,511.38	$13,803.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Facility		$9,332.54	$9,332.54	$9,332.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,918.31 / $6,918.31 / $9,332.54	Professional		$6,918.31	$6,918.31	$9,332.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $9,120.11 / $22,387.21 / $40,738.03	Facility		$9,120.11	$22,387.21	$40,738.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $9,120.11 / $18,197.01 / $33,113.11	Professional		$9,120.11	$18,197.01	$33,113.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $10,964.78 / $12,022.64	Professional		$75.86	$10,964.78	$12,022.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $14,125.38 / $14,454.40 / $19,054.61	Facility		$14,125.38	$14,454.40	$19,054.61
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $11,481.54 / $11,481.54 / $11,481.54	Professional		$11,481.54	$11,481.54	$11,481.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,589.25 / $20,892.96 / $30,902.95	Facility		$12,589.25	$20,892.96	$30,902.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $12,022.64 / $12,022.64 / $15,848.93	Professional		$12,022.64	$12,022.64	$15,848.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,125.38 / $14,125.38 / $14,125.38	Facility		$14,125.38	$14,125.38	$14,125.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $12,302.69 / $12,302.69 / $16,218.10	Professional		$12,302.69	$12,302.69	$16,218.10
United Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $23,442.29 / $23,442.29	Facility		$7,244.36	$23,442.29	$23,442.29
United Facility/Professional Professional Modifier Low / Median / High Price $6,760.83 / $9,549.93 / $13,489.63	Professional		$6,760.83	$9,549.93	$13,489.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $8,511.38 / $10,232.93 / $21,877.62	Professional		$8,511.38	$10,232.93	$21,877.62