Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $14,454.40 / $33,113.11	Facility		$812.83	$14,454.40	$33,113.11
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	22	$478.63	$478.63	$478.63
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,623.41 / $20,417.38 / $41,686.94	Facility	50	$5,623.41	$20,417.38	$41,686.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $645.65 / $1,905.46	Professional		$380.19	$645.65	$1,905.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $645.65 / $851.14	Professional		$107.15	$645.65	$851.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,071.52 / $8,128.31	Facility		$891.25	$1,071.52	$8,128.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $691.83 / $1,318.26	Professional		$436.52	$691.83	$1,318.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $912.01 / $7,244.36	Facility		$501.19	$912.01	$7,244.36
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $14,125.38 / $15,848.93 / $24,547.09	Facility	50	$14,125.38	$15,848.93	$24,547.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $812.83 / $3,801.89	Professional		$407.38	$812.83	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $251.19	Professional		$32.36	$33.11	$251.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $831.76 / $870.96	Facility		$660.69	$831.76	$870.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $602.56 / $4,073.80	Facility		$588.84	$602.56	$4,073.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $933.25 / $1,288.25	Professional		$602.56	$933.25	$1,288.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $16,218.10 / $31,622.78	Facility		$10,715.19	$16,218.10	$31,622.78
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $16,218.10 / $24,547.09 / $46,773.51	Facility	50	$16,218.10	$24,547.09	$46,773.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $831.76 / $1,096.48	Professional		$660.69	$831.76	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $19,054.61 / $33,884.42	Facility		$3,235.94	$19,054.61	$33,884.42
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $1,096.48	Professional		$416.87	$588.84	$1,096.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $489.78 / $794.33	Professional		$426.58	$489.78	$794.33