Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10,232.93 / $10,232.93 / $23,988.33	Facility		$10,232.93	$10,232.93	$23,988.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6,918.31 / $8,709.64 / $14,125.38	Professional		$6,918.31	$8,709.64	$14,125.38
Cigna 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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7,244.36 / $7,244.36 / $10,000.00	Professional		$7,244.36	$7,244.36	$10,000.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $9,120.11 / $21,379.62 / $44,668.36	Facility		$9,120.11	$21,379.62	$44,668.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $9,120.11 / $18,620.87 / $33,113.11	Professional		$9,120.11	$18,620.87	$33,113.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $12,022.64 / $13,182.57	Professional		$75.86	$12,022.64	$13,182.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $15,135.61 / $15,488.17 / $19,498.45	Facility		$15,135.61	$15,488.17	$19,498.45
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $12,302.69 / $12,302.69 / $12,302.69	Professional		$12,302.69	$12,302.69	$12,302.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $22,908.68 / $33,884.42	Facility		$13,803.84	$22,908.68	$33,884.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $12,882.50 / $12,882.50 / $16,982.44	Professional		$12,882.50	$12,882.50	$16,982.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,135.61 / $15,135.61 / $15,135.61	Facility		$15,135.61	$15,135.61	$15,135.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $13,489.63 / $13,489.63 / $17,378.01	Professional		$13,489.63	$13,489.63	$17,378.01
United Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $23,442.29 / $23,442.29	Facility		$7,585.78	$23,442.29	$23,442.29
United Facility/Professional Professional Modifier Low / Median / High Price $6,760.83 / $9,549.93 / $13,803.84	Professional		$6,760.83	$9,549.93	$13,803.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $8,912.51 / $11,220.18 / $23,988.33	Professional		$8,912.51	$11,220.18	$23,988.33