Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,818.38 / $11,481.54	Facility		$1,318.26	$2,818.38	$11,481.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,071.52 / $2,630.27	Professional		$741.31	$1,071.52	$2,630.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $2,187.76	Professional		$912.01	$912.01	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $912.01 / $1,513.56	Facility		$562.34	$912.01	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,513.56 / $2,818.38	Professional		$1,023.29	$1,513.56	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,905.46 / $2,951.21	Facility		$1,230.27	$1,905.46	$2,951.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,905.46 / $2,570.40	Professional		$1,258.93	$1,905.46	$2,570.40
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 $1,412.54 / $1,905.46 / $1,995.26	Facility		$1,412.54	$1,905.46	$1,995.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,318.26 / $1,380.38	Facility		$1,071.52	$1,318.26	$1,380.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,905.46 / $2,570.40	Professional		$1,148.15	$1,905.46	$2,570.40
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 $1,148.15 / $1,621.81 / $2,290.87	Professional		$1,148.15	$1,621.81	$2,290.87
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 $1,000.00 / $1,318.26 / $2,630.27	Professional		$1,000.00	$1,318.26	$2,630.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,023.29 / $1,445.44	Professional		$741.31	$1,023.29	$1,445.44