Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $3,388.44 / $18,620.87	Facility		$407.38	$3,388.44	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,000.00 / $12,022.64 / $13,182.57	Facility	50	$10,000.00	$12,022.64	$13,182.57
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
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $1,621.81 / $4,466.84	Facility		$323.59	$1,621.81	$4,466.84
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $8,128.31 / $12,882.50 / $25,118.86	Facility	50	$8,128.31	$12,882.50	$25,118.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,862.09 / $1,995.26	Facility		$1,348.96	$1,862.09	$1,995.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,380.38 / $1,380.38	Facility		$1,348.96	$1,380.38	$1,380.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $9,772.37 / $19,054.61	Facility		$6,606.93	$9,772.37	$19,054.61
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,000.00 / $14,791.08 / $28,183.83	Facility	50	$10,000.00	$14,791.08	$28,183.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $12,302.69 / $20,892.96	Facility		$2,454.71	$12,302.69	$20,892.96