Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $3,311.31 / $17,782.79	Facility		$213.80	$3,311.31	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $1,445.44 / $2,951.21	Professional		$114.82	$1,445.44	$2,951.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Professional	50	$2,691.53	$2,691.53	$2,691.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,230.27	Professional		$1,148.15	$1,148.15	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility		$2,344.23	$2,344.23	$2,344.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $1,905.46 / $3,890.45	Professional		$158.49	$1,905.46	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $1,949.84 / $7,762.47	Facility		$208.93	$1,949.84	$7,762.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $1,584.89 / $3,801.89	Professional		$208.93	$1,584.89	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,398.83 / $2,884.03	Facility		$1,698.24	$2,398.83	$2,884.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,862.09	Facility		$1,737.80	$1,737.80	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $389.05 / $3,235.94	Professional		$158.49	$389.05	$3,235.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $5,128.61 / $10,000.00	Facility		$3,801.89	$5,128.61	$10,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $354.81 / $2,951.21	Professional		$158.49	$354.81	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $7,413.10 / $12,302.69	Facility		$1,698.24	$7,413.10	$12,302.69
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $1,288.25 / $3,311.31	Professional		$154.88	$1,288.25	$3,311.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $194.98 / $2,570.40	Professional		$120.23	$194.98	$2,570.40