Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $6,456.54 / $18,620.87	Facility		$776.25	$6,456.54	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,456.54 / $15,488.17 / $30,199.52	Facility	50	$6,456.54	$15,488.17	$30,199.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $562.34 / $1,949.84	Professional		$389.05	$562.34	$1,949.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Professional		$407.38	$407.38	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $3,630.78	Facility		$2,187.76	$2,187.76	$3,630.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $933.25 / $1,479.11	Professional		$575.44	$933.25	$1,479.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,047.13 / $4,168.69	Facility		$575.44	$1,047.13	$4,168.69
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,309.57 / $12,589.25 / $26,915.35	Facility	50	$6,309.57	$12,589.25	$26,915.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,000.00 / $1,659.59	Professional		$575.44	$1,000.00	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,000.00 / $1,071.52	Facility		$741.31	$1,000.00	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,000.00 / $1,412.54	Professional		$588.84	$1,000.00	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $10,715.19 / $20,892.96	Facility		$7,079.46	$10,715.19	$20,892.96
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,715.19 / $16,218.10 / $30,902.95	Facility	50	$10,715.19	$16,218.10	$30,902.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,258.93	Professional		$602.56	$870.96	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $13,489.63 / $23,442.29	Facility		$1,995.26	$13,489.63	$23,442.29
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $741.31 / $1,445.44	Professional		$524.81	$741.31	$1,445.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $562.34 / $794.33	Professional		$380.19	$562.34	$794.33