Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $10,000.00 / $20,892.96	Facility		$1,148.15	$10,000.00	$20,892.96
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $11,220.18 / $18,197.01 / $43,651.58	Facility	50	$11,220.18	$18,197.01	$43,651.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $794.33 / $2,511.89	Professional		$478.63	$794.33	$2,511.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $812.83 / $1,047.13	Professional		$467.74	$812.83	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,071.52 / $3,981.07	Facility		$891.25	$1,071.52	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $831.76 / $1,584.89	Professional		$436.52	$831.76	$1,584.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,096.48 / $4,168.69	Facility		$588.84	$1,096.48	$4,168.69
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $9,549.93 / $10,964.78 / $16,595.87	Facility	50	$9,549.93	$10,964.78	$16,595.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $977.24 / $2,187.76	Professional		$489.78	$977.24	$2,187.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $302.00	Professional		$32.36	$33.11	$302.00
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 $707.95 / $724.44 / $2,691.53	Facility		$707.95	$724.44	$2,691.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,122.02 / $1,548.82	Professional		$724.44	$1,122.02	$1,548.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $9,772.37 / $18,620.87	Facility		$7,079.46	$9,772.37	$18,620.87
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,715.19 / $14,791.08 / $28,183.83	Facility	50	$10,715.19	$14,791.08	$28,183.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,318.26	Professional		$794.33	$1,000.00	$1,318.26
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $11,220.18 / $19,952.62	Facility		$2,137.96	$11,220.18	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $724.44 / $1,318.26	Professional		$501.19	$724.44	$1,318.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $575.44 / $954.99	Professional		$501.19	$575.44	$954.99