Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $6,456.54 / $22,908.68	Facility		$316.23	$6,456.54	$22,908.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $2,187.76 / $4,897.79	Professional		$162.18	$2,187.76	$4,897.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $10,000.00	Facility		$6,025.60	$6,025.60	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $562.34 / $7,585.78	Professional		$263.03	$562.34	$7,585.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $4,677.35 / $10,964.78	Facility		$263.03	$4,677.35	$10,964.78
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $14,454.40 / $23,988.33 / $41,686.94	Facility	50	$14,454.40	$23,988.33	$41,686.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $3,630.78 / $7,585.78	Professional		$263.03	$3,630.78	$7,585.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $4,677.35 / $5,011.87	Facility		$3,162.28	$4,677.35	$5,011.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $3,630.78 / $3,630.78	Facility		$3,388.44	$3,630.78	$3,630.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $588.84 / $6,760.83	Professional		$234.42	$588.84	$6,760.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $16,595.87 / $31,622.78	Facility		$12,022.64	$16,595.87	$31,622.78
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $14,791.08 / $17,782.79 / $31,622.78	Facility	50	$14,791.08	$17,782.79	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $3,090.30 / $6,309.57	Professional		$257.04	$3,090.30	$6,309.57
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $20,417.38 / $35,481.34	Facility		$3,467.37	$20,417.38	$35,481.34
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $2,398.83 / $7,079.46	Professional		$223.87	$2,398.83	$7,079.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $275.42 / $3,548.13	Professional		$144.54	$275.42	$3,548.13