Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12,589.25 / $12,589.25 / $29,512.09	Facility		$12,589.25	$12,589.25	$29,512.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8,511.38 / $11,481.54 / $20,417.38	Professional		$8,511.38	$11,481.54	$20,417.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $13,803.84 / $13,803.84	Facility		$13,803.84	$13,803.84	$13,803.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10,000.00 / $10,000.00 / $13,803.84	Professional		$10,000.00	$10,000.00	$13,803.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $28,840.32 / $54,954.09	Facility		$12,022.64	$28,840.32	$54,954.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12,022.64 / $24,547.09 / $44,668.36	Professional		$12,022.64	$24,547.09	$44,668.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $14,791.08 / $16,218.10	Professional		$75.86	$14,791.08	$16,218.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $18,620.87 / $19,054.61 / $22,908.68	Facility		$18,620.87	$19,054.61	$22,908.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $15,135.61 / $15,135.61 / $15,135.61	Professional		$15,135.61	$15,135.61	$15,135.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $16,982.44 / $28,183.83 / $40,738.03	Facility		$16,982.44	$28,183.83	$40,738.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15,848.93 / $15,848.93 / $21,877.62	Professional		$15,848.93	$15,848.93	$21,877.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18,620.87 / $18,620.87 / $18,620.87	Facility		$18,620.87	$18,620.87	$18,620.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $16,218.10 / $16,595.87 / $21,379.62	Professional		$16,218.10	$16,595.87	$21,379.62
United Facility/Professional Facility Modifier Low / Median / High Price $12,589.25 / $31,622.78 / $31,622.78	Facility		$12,589.25	$31,622.78	$31,622.78
United Facility/Professional Professional Modifier Low / Median / High Price $8,912.51 / $12,882.50 / $18,197.01	Professional		$8,912.51	$12,882.50	$18,197.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11,748.98 / $13,803.84 / $29,512.09	Professional		$11,748.98	$13,803.84	$29,512.09