Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,454.71 / $17,782.79	Facility		$1,230.27	$2,454.71	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $954.99 / $2,238.72	Professional		$691.83	$954.99	$2,238.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,122.02 / $2,344.23	Facility		$645.65	$1,122.02	$2,344.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,412.54 / $2,570.40	Professional		$954.99	$1,412.54	$2,570.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,819.70 / $2,951.21	Facility		$1,148.15	$1,819.70	$2,951.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $2,511.89	Professional		$1,148.15	$1,778.28	$2,511.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,778.28 / $1,862.09	Facility		$1,288.25	$1,778.28	$1,862.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,230.27 / $1,288.25	Facility		$1,071.52	$1,230.27	$1,288.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,819.70 / $2,398.83	Professional		$1,096.48	$1,819.70	$2,398.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $5,128.61 / $10,000.00	Facility		$3,548.13	$5,128.61	$10,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,548.82 / $2,137.96	Professional		$1,071.52	$1,548.82	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $6,918.31 / $11,748.98	Facility		$1,047.13	$6,918.31	$11,748.98
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,230.27 / $2,454.71	Professional		$933.25	$1,230.27	$2,454.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $954.99 / $1,348.96	Professional		$707.95	$954.99	$1,348.96