Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11,481.54 / $11,481.54 / $26,915.35	Facility		$11,481.54	$11,481.54	$26,915.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7,762.47 / $10,471.29 / $20,417.38	Professional		$7,762.47	$10,471.29	$20,417.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12,589.25 / $12,589.25 / $12,589.25	Facility		$12,589.25	$12,589.25	$12,589.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9,120.11 / $9,120.11 / $12,589.25	Professional		$9,120.11	$9,120.11	$12,589.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $26,302.68 / $50,118.72	Facility		$10,964.78	$26,302.68	$50,118.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10,964.78 / $22,387.21 / $40,738.03	Professional		$10,964.78	$22,387.21	$40,738.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $13,489.63 / $14,791.08	Professional		$75.86	$13,489.63	$14,791.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $16,982.44 / $17,378.01 / $21,379.62	Facility		$16,982.44	$17,378.01	$21,379.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $13,803.84 / $13,803.84 / $13,803.84	Professional		$13,803.84	$13,803.84	$13,803.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $15,488.17 / $25,703.96 / $38,018.94	Facility		$15,488.17	$25,703.96	$38,018.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $14,454.40 / $14,454.40 / $19,054.61	Professional		$14,454.40	$14,454.40	$19,054.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $16,982.44 / $16,982.44 / $16,982.44	Facility		$16,982.44	$16,982.44	$16,982.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $15,135.61 / $15,135.61 / $19,498.45	Professional		$15,135.61	$15,135.61	$19,498.45
United Facility/Professional Facility Modifier Low / Median / High Price $9,332.54 / $28,840.32 / $28,840.32	Facility		$9,332.54	$28,840.32	$28,840.32
United Facility/Professional Professional Modifier Low / Median / High Price $8,128.31 / $11,748.98 / $16,595.87	Professional		$8,128.31	$11,748.98	$16,595.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10,715.19 / $12,589.25 / $26,915.35	Professional		$10,715.19	$12,589.25	$26,915.35