Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $9,120.11 / $19,054.61	Facility		$691.83	$9,120.11	$19,054.61
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,000.00 / $16,982.44 / $18,197.01	Facility	50	$10,000.00	$16,982.44	$18,197.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $575.44 / $1,905.46	Professional		$354.81	$575.44	$1,905.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $758.58 / $1,071.52	Professional		$660.69	$758.58	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $3,630.78	Facility		$2,187.76	$2,187.76	$3,630.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $912.01 / $1,445.44	Professional		$537.03	$912.01	$1,445.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,023.29 / $4,168.69	Facility		$562.34	$1,023.29	$4,168.69
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,456.54 / $12,589.25 / $26,915.35	Facility	50	$6,456.54	$12,589.25	$26,915.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,000.00 / $1,621.81	Professional		$562.34	$1,000.00	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $954.99 / $1,047.13	Facility		$676.08	$954.99	$1,047.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $724.44 / $724.44	Facility		$707.95	$724.44	$724.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,000.00 / $1,412.54	Professional		$588.84	$1,000.00	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $10,715.19 / $20,892.96	Facility		$7,079.46	$10,715.19	$20,892.96
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,715.19 / $16,218.10 / $30,902.95	Facility	50	$10,715.19	$16,218.10	$30,902.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $870.96 / $1,230.27	Professional		$616.60	$870.96	$1,230.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $13,489.63 / $23,442.29	Facility		$1,995.26	$13,489.63	$23,442.29
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $707.95 / $1,380.38	Professional		$501.19	$707.95	$1,380.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $575.44 / $812.83	Professional		$407.38	$575.44	$812.83