Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $8,912.51 / $17,782.79	Facility		$1,288.25	$8,912.51	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $954.99 / $2,884.03	Professional		$489.78	$954.99	$2,884.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,122.02 / $1,318.26	Professional		$575.44	$1,122.02	$1,318.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility		$3,311.31	$3,311.31	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,288.25 / $2,089.30	Professional		$724.44	$1,288.25	$2,089.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,584.89 / $8,317.64	Facility		$870.96	$1,584.89	$8,317.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,479.11 / $2,691.53	Professional		$812.83	$1,479.11	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,230.27 / $1,380.38	Facility		$891.25	$1,230.27	$1,380.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $933.25 / $933.25	Facility		$912.01	$933.25	$933.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,548.82 / $1,949.84	Professional		$933.25	$1,548.82	$1,949.84
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 $933.25 / $1,318.26 / $1,737.80	Professional		$933.25	$1,318.26	$1,737.80
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 $616.60 / $977.24 / $1,905.46	Professional		$616.60	$977.24	$1,905.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $1,202.26	Professional		$630.96	$851.14	$1,202.26