Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $8,128.31 / $21,877.62	Facility		$1,737.80	$8,128.31	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,174.90 / $2,754.23	Professional		$831.76	$1,174.90	$2,754.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $1,380.38	Professional		$186.21	$186.21	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,071.52 / $2,398.83	Facility		$891.25	$1,071.52	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,513.56 / $2,818.38	Professional		$912.01	$1,513.56	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,412.54 / $2,570.40	Facility		$954.99	$1,412.54	$2,570.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,412.54 / $2,290.87	Professional		$912.01	$1,412.54	$2,290.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,778.28 / $1,905.46	Facility		$1,348.96	$1,778.28	$1,905.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,288.25	Facility		$1,258.93	$1,258.93	$1,288.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,995.26 / $2,691.53	Professional		$1,288.25	$1,995.26	$2,691.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $4,677.35 / $8,912.51	Facility		$3,467.37	$4,677.35	$8,912.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,778.28 / $2,398.83	Professional		$1,288.25	$1,778.28	$2,398.83
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $6,025.60 / $12,882.50	Facility		$3,467.37	$6,025.60	$12,882.50
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,412.54 / $2,570.40	Professional		$933.25	$1,412.54	$2,570.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,000.00 / $1,621.81	Professional		$870.96	$1,000.00	$1,621.81