Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $7,762.47 / $20,892.96	Facility		$1,023.29	$7,762.47	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $645.65 / $1,548.82	Professional		$501.19	$645.65	$1,548.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $831.76 / $891.25	Professional		$549.54	$831.76	$891.25
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 $630.96 / $1,023.29 / $1,659.59	Professional		$630.96	$1,023.29	$1,659.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,348.96 / $8,317.64	Facility		$707.95	$1,348.96	$8,317.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,202.26 / $2,691.53	Professional		$707.95	$1,202.26	$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 $831.76 / $1,023.29 / $1,096.48	Facility		$831.76	$1,023.29	$1,096.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $741.31 / $741.31	Facility		$724.44	$741.31	$741.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,230.27 / $1,584.89	Professional		$741.31	$1,230.27	$1,584.89
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 $741.31 / $1,047.13 / $1,380.38	Professional		$741.31	$1,047.13	$1,380.38
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 $512.86 / $831.76 / $1,513.56	Professional		$512.86	$831.76	$1,513.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $676.08 / $954.99	Professional		$501.19	$676.08	$954.99