Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $3,388.44 / $18,620.87	Facility		$794.33	$3,388.44	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $912.01 / $2,754.23	Professional		$331.13	$912.01	$2,754.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,778.28 / $2,137.96	Professional		$338.84	$1,778.28	$2,137.96
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 $512.86 / $1,174.90 / $2,818.38	Professional		$512.86	$1,174.90	$2,818.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,348.96 / $3,801.89	Facility		$512.86	$1,348.96	$3,801.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $1,202.26 / $2,630.27	Professional		$524.81	$1,202.26	$2,630.27
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 $1,202.26 / $1,737.80 / $1,995.26	Facility		$1,202.26	$1,737.80	$1,995.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,258.93 / $2,570.40	Professional		$575.44	$1,258.93	$2,570.40
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 Professional Modifier Low / Median / High Price $512.86 / $1,174.90 / $2,344.23	Professional		$512.86	$1,174.90	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $11,481.54 / $19,952.62	Facility		$1,698.24	$11,481.54	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $954.99 / $2,454.71	Professional		$436.52	$954.99	$2,454.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $724.44 / $1,412.54	Professional		$380.19	$724.44	$1,412.54