Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $10,232.93 / $26,915.35	Facility		$977.24	$10,232.93	$26,915.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $933.25 / $3,467.37	Professional		$724.44	$933.25	$3,467.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,096.48 / $1,318.26	Professional		$933.25	$1,096.48	$1,318.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $6,025.60	Facility		$3,548.13	$3,548.13	$6,025.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,445.44 / $2,187.76	Professional		$870.96	$1,445.44	$2,187.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,737.80 / $13,182.57	Facility		$1,047.13	$1,737.80	$13,182.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $4,897.79	Professional		$1,047.13	$1,621.81	$4,897.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,412.54 / $1,621.81	Facility		$1,202.26	$1,412.54	$1,621.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,000.00 / $1,000.00	Facility		$954.99	$1,000.00	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,621.81 / $2,137.96	Professional		$1,000.00	$1,621.81	$2,137.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,772.37 / $14,791.08 / $28,183.83	Facility		$9,772.37	$14,791.08	$28,183.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,380.38 / $1,862.09	Professional		$977.24	$1,380.38	$1,862.09
United Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $18,620.87 / $32,359.37	Facility		$3,467.37	$18,620.87	$32,359.37
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,230.27 / $2,089.30	Professional		$724.44	$1,230.27	$2,089.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $1,000.00	Professional		$524.81	$707.95	$1,000.00