Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $8,128.31 / $24,547.09	Facility		$707.95	$8,128.31	$24,547.09
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	22	$2,511.89	$2,511.89	$2,511.89
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,365.16 / $8,912.51 / $37,153.52	Facility	50	$4,365.16	$8,912.51	$37,153.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $5,754.40	Facility		$3,467.37	$3,467.37	$5,754.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $891.25 / $16,982.44	Facility		$588.84	$891.25	$16,982.44
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $7,762.47 / $21,877.62 / $48,977.88	Facility	50	$7,762.47	$21,877.62	$48,977.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $724.44 / $977.24	Facility		$616.60	$724.44	$977.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $512.86 / $512.86	Facility		$501.19	$512.86	$512.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $19,498.45 / $37,153.52	Facility		$12,882.50	$19,498.45	$37,153.52
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $19,054.61 / $28,840.32 / $56,234.13	Facility	50	$19,054.61	$28,840.32	$56,234.13
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $24,547.09 / $42,657.95	Facility		$2,454.71	$24,547.09	$42,657.95