Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,621.81 / $13,803.84	Facility		$660.69	$1,621.81	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $691.83 / $1,778.28	Professional		$331.13	$691.83	$1,778.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $676.08 / $1,288.25	Professional		$457.09	$676.08	$1,288.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $512.86 / $776.25	Facility		$416.87	$512.86	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $851.14 / $1,778.28	Professional		$446.68	$851.14	$1,778.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $891.25 / $1,778.28	Facility		$524.81	$891.25	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $891.25 / $1,659.59	Professional		$537.03	$891.25	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,258.93 / $1,380.38	Facility		$912.01	$1,258.93	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $891.25 / $933.25	Facility		$354.81	$891.25	$933.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $933.25 / $1,698.24	Professional		$478.63	$933.25	$1,698.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,778.28 / $3,388.44	Facility		$1,202.26	$1,778.28	$3,388.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $870.96 / $1,348.96	Professional		$478.63	$870.96	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $2,570.40 / $5,754.40	Facility		$501.19	$2,570.40	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $851.14 / $1,659.59	Professional		$446.68	$851.14	$1,659.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $549.54 / $977.24	Professional		$288.40	$549.54	$977.24