Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $2,818.38 / $18,620.87	Facility		$933.25	$2,818.38	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,290.87 / $2,290.87 / $6,165.95	Facility	50	$2,290.87	$2,290.87	$6,165.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $676.08 / $1,621.81	Professional		$457.09	$676.08	$1,621.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,148.15 / $1,479.11 / $3,388.44	Professional	50	$1,148.15	$1,479.11	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $2,454.71	Facility		$912.01	$912.01	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $870.96 / $1,621.81	Professional		$562.34	$870.96	$1,621.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,122.02 / $2,290.87	Facility		$616.60	$1,122.02	$2,290.87
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,754.40 / $9,332.54 / $16,595.87	Facility	50	$5,754.40	$9,332.54	$16,595.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,122.02 / $1,621.81	Professional		$616.60	$1,122.02	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $389.05	Professional		$32.36	$33.11	$389.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,122.02 / $1,202.26	Facility		$851.14	$1,122.02	$1,202.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $831.76	Facility		$812.83	$812.83	$831.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,148.15 / $1,548.82	Professional		$676.08	$1,148.15	$1,548.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $6,606.93 / $12,589.25	Facility		$4,365.16	$6,606.93	$12,589.25
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $6,606.93 / $10,000.00 / $19,054.61	Facility	50	$6,606.93	$10,000.00	$19,054.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,148.15 / $1,548.82	Professional		$812.83	$1,148.15	$1,548.82
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $7,413.10 / $13,489.63	Facility		$1,380.38	$7,413.10	$13,489.63
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $812.83 / $1,513.56	Professional		$588.84	$812.83	$1,513.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $724.44 / $1,174.90	Professional		$79.43	$724.44	$1,174.90