Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $7,762.47 / $14,125.38	Facility		$1,000.00	$7,762.47	$14,125.38
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,454.71 / $8,912.51 / $14,125.38	Facility	50	$2,454.71	$8,912.51	$14,125.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $741.31 / $2,290.87	Professional		$467.74	$741.31	$2,290.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $776.25 / $1,348.96	Professional		$389.05	$776.25	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,995.26 / $3,548.13	Facility		$1,862.09	$1,995.26	$3,548.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $851.14 / $1,584.89	Professional		$489.78	$851.14	$1,584.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,023.29 / $2,041.74	Facility		$549.54	$1,023.29	$2,041.74
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $3,890.45 / $6,456.54 / $11,220.18	Facility	50	$3,890.45	$6,456.54	$11,220.18
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 / $239.88	Professional		$32.36	$33.11	$239.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $977.24 / $1,047.13	Facility		$724.44	$977.24	$1,047.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $724.44	Facility		$691.83	$691.83	$724.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,122.02 / $1,513.56	Professional		$724.44	$1,122.02	$1,513.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $4,677.35 / $8,709.64	Facility		$3,467.37	$4,677.35	$8,709.64
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,248.07 / $7,079.46 / $13,182.57	Facility	50	$5,248.07	$7,079.46	$13,182.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $977.24 / $1,318.26	Professional		$707.95	$977.24	$1,318.26
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $6,025.60 / $12,022.64	Facility		$2,454.71	$6,025.60	$12,022.64
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $741.31 / $1,412.54	Professional		$512.86	$741.31	$1,412.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $562.34 / $933.25	Professional		$489.78	$562.34	$933.25