Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $6,025.60 / $18,620.87	Facility		$891.25	$6,025.60	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $562.34 / $1,380.38	Professional		$407.38	$562.34	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $3,311.31	Facility		$1,995.26	$1,995.26	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $891.25 / $1,445.44	Professional		$501.19	$891.25	$1,445.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,122.02 / $8,317.64	Facility		$602.56	$1,122.02	$8,317.64
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $4,365.16 / $10,964.78 / $22,387.21	Facility	50	$4,365.16	$10,964.78	$22,387.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,047.13 / $2,691.53	Professional		$575.44	$1,047.13	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $851.14 / $954.99	Facility		$616.60	$851.14	$954.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,071.52 / $1,348.96	Professional		$645.65	$1,071.52	$1,348.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,120.11 / $17,378.01	Facility		$5,888.44	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,912.51 / $13,803.84 / $26,302.68	Facility	50	$8,912.51	$13,803.84	$26,302.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $912.01 / $1,230.27	Professional		$645.65	$912.01	$1,230.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,481.54 / $19,952.62	Facility		$1,995.26	$11,481.54	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $676.08 / $1,318.26	Professional		$436.52	$676.08	$1,318.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $602.56 / $851.14	Professional		$446.68	$602.56	$851.14