Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $10,232.93 / $28,183.83	Facility		$173.78	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $151.36 / $173.78	Professional		$83.18	$151.36	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $6,025.60	Facility		$3,548.13	$3,548.13	$6,025.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $6,165.95 / $19,054.61	Facility		$3,467.37	$6,165.95	$19,054.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $4,265.80 / $6,309.57	Professional		$2,818.38	$4,265.80	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $75.86	Professional		$33.11	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $331.13 / $4,265.80	Facility		$229.09	$331.13	$4,265.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $371.54 / $478.63	Professional		$223.87	$371.54	$478.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $13,182.57 / $25,118.86	Facility		$8,511.38	$13,182.57	$25,118.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $309.03 / $426.58	Professional		$229.09	$309.03	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $16,218.10 / $26,302.68	Facility		$3,467.37	$16,218.10	$26,302.68
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $239.88 / $457.09	Professional		$165.96	$239.88	$457.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47