Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $4,677.35 / $20,892.96	Facility		$1,047.13	$4,677.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $741.31 / $1,949.84	Professional		$467.74	$741.31	$1,949.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $2,398.83	Facility		$707.95	$870.96	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $851.14 / $1,698.24	Professional		$501.19	$851.14	$1,698.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,023.29 / $2,238.72	Facility		$549.54	$1,023.29	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $1,000.00 / $1,621.81	Professional		$489.78	$1,000.00	$1,621.81
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 $691.83 / $977.24 / $1,122.02	Facility		$691.83	$977.24	$1,122.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,174.90 / $1,584.89	Professional		$758.58	$1,174.90	$1,584.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,570.88 / $8,709.64	Facility		$3,311.31	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,047.13 / $1,412.54	Professional		$758.58	$1,047.13	$1,412.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $5,495.41 / $9,120.11	Facility		$1,122.02	$5,495.41	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $758.58 / $1,445.44	Professional		$537.03	$758.58	$1,445.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $1,071.52	Professional		$562.34	$645.65	$1,071.52