Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $12,589.25	Facility		$5,248.07	$5,248.07	$12,589.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $4,570.88 / $7,244.36	Professional		$3,548.13	$4,570.88	$7,244.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,786.30	Professional		$4,073.80	$4,073.80	$4,786.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $11,220.18 / $23,442.29	Facility		$4,786.30	$11,220.18	$23,442.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $10,000.00 / $17,782.79	Professional		$4,786.30	$10,000.00	$17,782.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $7,943.28 / $8,709.64	Professional		$75.86	$7,943.28	$8,709.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $8,128.31 / $8,511.38	Facility		$7,943.28	$8,128.31	$8,511.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,332.54 / $12,302.69 / $19,054.61	Facility		$9,332.54	$12,302.69	$19,054.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,585.78 / $7,943.28 / $9,332.54	Professional		$7,585.78	$7,943.28	$9,332.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Facility		$7,943.28	$7,943.28	$7,943.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $7,079.46 / $7,079.46 / $9,120.11	Professional		$7,079.46	$7,079.46	$9,120.11
United Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $12,302.69 / $12,302.69	Facility		$5,011.87	$12,302.69	$12,302.69
United Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $5,248.07 / $7,244.36	Professional		$3,548.13	$5,248.07	$7,244.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $6,456.54 / $12,589.25	Professional		$5,888.44	$6,456.54	$12,589.25