Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $2,570.40 / $19,952.62	Facility		$1,047.13	$2,570.40	$19,952.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,786.30 / $7,585.78 / $9,332.54	Facility	50	$4,786.30	$7,585.78	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $676.08 / $1,737.80	Professional		$478.63	$676.08	$1,737.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $691.83 / $1,380.38 / $4,786.30	Professional	50	$691.83	$1,380.38	$4,786.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,412.54 / $2,344.23	Facility		$912.01	$1,412.54	$2,344.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $954.99 / $1,737.80	Professional		$645.65	$954.99	$1,737.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,258.93 / $2,951.21	Facility		$776.25	$1,258.93	$2,951.21
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,370.32 / $7,762.47 / $13,489.63	Facility	50	$5,370.32	$7,762.47	$13,489.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,230.27 / $1,819.70	Professional		$776.25	$1,230.27	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $354.81	Professional		$32.36	$33.11	$354.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,174.90 / $1,258.93	Facility		$870.96	$1,174.90	$1,258.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $851.14	Facility		$831.76	$831.76	$851.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,230.27 / $1,621.81	Professional		$758.58	$1,230.27	$1,621.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $5,128.61 / $10,000.00	Facility		$3,801.89	$5,128.61	$10,000.00
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,623.41 / $7,762.47 / $14,791.08	Facility	50	$5,623.41	$7,762.47	$14,791.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,047.13 / $1,479.11	Professional		$724.44	$1,047.13	$1,479.11
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 $630.96 / $831.76 / $1,659.59	Professional		$630.96	$831.76	$1,659.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $933.25	Professional		$489.78	$660.69	$933.25