Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $11,481.54 / $18,620.87	Facility		$1,202.26	$11,481.54	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $794.33 / $2,511.89	Professional		$645.65	$794.33	$2,511.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,148.15 / $1,230.27	Professional		$616.60	$1,148.15	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Facility		$3,801.89	$3,801.89	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,202.26 / $1,905.46	Professional		$794.33	$1,202.26	$1,905.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $13,803.84	Facility		$1,023.29	$1,584.89	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,479.11 / $3,388.44	Professional		$1,023.29	$1,479.11	$3,388.44
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 $1,000.00 / $1,230.27 / $1,318.26	Facility		$1,000.00	$1,230.27	$1,318.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,445.44 / $1,905.46	Professional		$891.25	$1,445.44	$1,905.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $9,120.11 / $17,378.01	Facility		$6,918.31	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,288.25 / $1,698.24	Professional		$891.25	$1,288.25	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $11,748.98 / $19,054.61	Facility		$3,311.31	$11,748.98	$19,054.61
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $977.24 / $1,819.70	Professional		$630.96	$977.24	$1,819.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $794.33 / $1,122.02	Professional		$676.08	$794.33	$1,122.02