Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $9,120.11 / $28,183.83	Facility		$1,513.56	$9,120.11	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,096.48 / $3,715.35	Professional		$691.83	$1,096.48	$3,715.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Professional		$2,398.83	$2,398.83	$2,398.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $758.58 / $10,000.00	Facility		$630.96	$758.58	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,258.93 / $2,454.71	Professional		$741.31	$1,258.93	$2,454.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,584.89 / $8,128.31	Facility		$741.31	$1,584.89	$8,128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,479.11 / $6,309.57	Professional		$741.31	$1,479.11	$6,309.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $363.08	Professional		$32.36	$33.11	$363.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,479.11 / $1,621.81	Facility		$1,174.90	$1,479.11	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,096.48 / $2,187.76	Facility		$1,071.52	$1,096.48	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,698.24 / $2,290.87	Professional		$1,096.48	$1,698.24	$2,290.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $20,417.38 / $38,904.51	Facility		$13,803.84	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,513.56 / $2,041.74	Professional		$1,096.48	$1,513.56	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $21,379.62 / $41,686.94	Facility		$1,995.26	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,122.02 / $2,089.30	Professional		$758.58	$1,122.02	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $870.96 / $1,445.44	Professional		$758.58	$870.96	$1,445.44