Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $5,623.41 / $10,000.00	Facility		$616.60	$5,623.41	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $501.19 / $2,691.53	Professional		$144.54	$501.19	$2,691.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $275.42 / $1,047.13	Professional		$239.88	$275.42	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,659.59	Facility		$1,000.00	$1,000.00	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $524.81 / $1,479.11	Professional		$257.04	$524.81	$1,479.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $977.24 / $1,949.84	Facility		$263.03	$977.24	$1,949.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $812.83 / $1,548.82	Professional		$275.42	$812.83	$1,548.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $954.99 / $1,318.26	Facility		$794.33	$954.99	$1,318.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $691.83	Facility		$676.08	$676.08	$691.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $562.34 / $1,318.26	Professional		$223.87	$562.34	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,570.88 / $8,709.64	Facility		$3,090.30	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $602.56 / $1,288.25	Professional		$245.47	$602.56	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,165.95 / $9,772.37	Facility		$1,698.24	$6,165.95	$9,772.37
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $549.54 / $1,412.54	Professional		$223.87	$549.54	$1,412.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $263.03 / $691.83	Professional		$138.04	$263.03	$691.83