Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $10,232.93 / $28,183.83	Facility		$977.24	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $912.01 / $1,071.52	Professional		$575.44	$912.01	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $4,168.69 / $6,918.31	Facility		$1,905.46	$4,168.69	$6,918.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Professional		$1,548.82	$1,548.82	$1,548.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,981.07 / $17,782.79	Facility		$3,235.94	$3,981.07	$17,782.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,715.35 / $8,128.31	Professional		$3,162.28	$3,715.35	$8,128.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $75.86	Professional		$32.36	$44.67	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,949.84 / $5,495.41	Facility		$1,348.96	$1,949.84	$5,495.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,318.26 / $2,754.23	Facility		$1,258.93	$1,318.26	$2,754.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,089.30 / $2,818.38	Professional		$1,318.26	$2,089.30	$2,818.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $11,481.54 / $21,877.62	Facility		$8,317.64	$11,481.54	$21,877.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,862.09 / $2,691.53	Professional		$1,288.25	$1,862.09	$2,691.53
United Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $12,882.50 / $22,908.68	Facility		$2,398.83	$12,882.50	$22,908.68
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,548.82 / $2,818.38	Professional		$1,047.13	$1,548.82	$2,818.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $0.02 / $1,995.26	Professional		$0.02	$0.02	$1,995.26