Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $14,454.40 / $24,547.09	Facility		$2,511.89	$14,454.40	$24,547.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $4,570.88	Professional		$1,174.90	$1,659.59	$4,570.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $6,165.95	Facility		$1,905.46	$1,905.46	$6,165.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,137.96 / $4,073.80	Professional		$1,318.26	$2,137.96	$4,073.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $3,162.28 / $10,964.78	Facility		$1,995.26	$3,162.28	$10,964.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,951.21 / $5,011.87	Professional		$1,995.26	$2,951.21	$5,011.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $758.58	Professional		$32.36	$33.11	$758.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,570.40 / $2,691.53	Facility		$2,137.96	$2,570.40	$2,691.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,778.28 / $1,778.28	Facility		$1,737.80	$1,778.28	$1,778.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,951.21 / $3,801.89	Professional		$1,778.28	$2,951.21	$3,801.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,549.93 / $14,791.08 / $28,183.83	Facility		$9,549.93	$14,791.08	$28,183.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,691.53 / $4,073.80	Professional		$1,778.28	$2,691.53	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $16,218.10 / $30,199.52	Facility		$2,398.83	$16,218.10	$30,199.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,137.96 / $3,630.78	Professional		$1,479.11	$2,137.96	$3,630.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $1,513.56 / $2,137.96	Professional		$173.78	$1,513.56	$2,137.96