Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $12,302.69 / $19,952.62	Facility		$1,000.00	$12,302.69	$19,952.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,715.19 / $12,882.50 / $12,882.50	Facility	50	$10,715.19	$12,882.50	$12,882.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $812.83 / $2,691.53	Professional		$588.84	$812.83	$2,691.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $977.24 / $1,122.02	Professional		$630.96	$977.24	$1,122.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $3,890.45	Facility		$2,344.23	$2,344.23	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,318.26 / $2,089.30	Professional		$758.58	$1,318.26	$2,089.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,445.44 / $4,466.84	Facility		$812.83	$1,445.44	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $8,709.64 / $14,125.38 / $25,118.86	Facility	50	$8,709.64	$14,125.38	$25,118.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,089.30	Professional		$812.83	$1,380.38	$2,089.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $257.04	Professional		$32.36	$33.11	$257.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,412.54 / $1,479.11	Facility		$1,148.15	$1,412.54	$1,479.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,023.29 / $1,023.29	Facility		$1,000.00	$1,023.29	$1,023.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,380.38 / $1,949.84	Professional		$794.33	$1,380.38	$1,949.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $9,772.37 / $19,054.61	Facility		$7,244.36	$9,772.37	$19,054.61
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 $851.14 / $1,202.26 / $1,778.28	Professional		$851.14	$1,202.26	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $13,182.57 / $20,892.96	Facility		$4,265.80	$13,182.57	$20,892.96
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,122.02 / $1,949.84	Professional		$724.44	$1,122.02	$1,949.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $776.25 / $1,096.48	Professional		$524.81	$776.25	$1,096.48