Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,778.28 / $18,620.87	Facility		$812.83	$1,778.28	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $602.56 / $1,621.81	Professional		$398.11	$602.56	$1,621.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $4,466.84	Facility		$707.95	$870.96	$4,466.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $831.76 / $1,698.24	Professional		$457.09	$831.76	$1,698.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $891.25 / $2,884.03	Facility		$512.86	$891.25	$2,884.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $870.96 / $1,862.09	Professional		$512.86	$870.96	$1,862.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $346.74	Professional		$32.36	$33.11	$346.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,148.15 / $1,174.90	Facility		$812.83	$1,148.15	$1,174.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $794.33 / $977.24	Facility		$776.25	$794.33	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,047.13 / $1,445.44	Professional		$602.56	$1,047.13	$1,445.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $9,120.11 / $17,378.01	Facility		$6,165.95	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $912.01 / $1,380.38	Professional		$575.44	$912.01	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $10,471.29 / $18,620.87	Facility		$1,995.26	$10,471.29	$18,620.87
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $758.58 / $1,479.11	Professional		$512.86	$758.58	$1,479.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $602.56 / $851.14	Professional		$416.87	$602.56	$851.14