Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $9,332.54 / $25,703.96	Facility		$1,479.11	$9,332.54	$25,703.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,071.52 / $3,801.89	Professional		$707.95	$1,071.52	$3,801.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,071.52 / $10,000.00	Facility		$891.25	$1,071.52	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,258.93 / $2,344.23	Professional		$758.58	$1,258.93	$2,344.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,584.89 / $9,549.93	Facility		$794.33	$1,584.89	$9,549.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,513.56 / $6,309.57	Professional		$794.33	$1,513.56	$6,309.57
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 $1,122.02 / $1,479.11 / $1,548.82	Facility		$1,122.02	$1,479.11	$1,548.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,071.52 / $2,187.76	Facility		$1,023.29	$1,071.52	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,659.59 / $2,238.72	Professional		$1,071.52	$1,659.59	$2,238.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,791.08 / $20,417.38 / $38,904.51	Facility		$14,791.08	$20,417.38	$38,904.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,479.11 / $1,995.26	Professional		$1,047.13	$1,479.11	$1,995.26
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $21,379.62 / $41,686.94	Facility		$3,467.37	$21,379.62	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,148.15 / $2,089.30	Professional		$776.25	$1,148.15	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $812.83 / $1,348.96	Professional		$707.95	$812.83	$1,348.96