Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $3,548.13 / $18,620.87	Facility		$831.76	$3,548.13	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,309.57 / $6,309.57 / $8,912.51	Facility	50	$6,309.57	$6,309.57	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $645.65 / $2,089.30	Professional		$416.87	$645.65	$2,089.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $776.25 / $3,801.89	Professional	50	$77.62	$776.25	$3,801.89
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 $489.78 / $741.31 / $1,479.11	Professional		$489.78	$741.31	$1,479.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,023.29 / $2,290.87	Facility		$537.03	$1,023.29	$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 $537.03 / $1,000.00 / $1,479.11	Professional		$537.03	$1,000.00	$1,479.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $346.74	Professional		$32.36	$33.11	$346.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $977.24 / $1,096.48	Facility		$691.83	$977.24	$1,096.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $741.31 / $776.25	Facility		$724.44	$741.31	$776.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,023.29 / $1,348.96	Professional		$602.56	$1,023.29	$1,348.96
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 $741.31 / $1,023.29 / $1,445.44	Professional		$741.31	$1,023.29	$1,445.44
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 $512.86 / $707.95 / $1,348.96	Professional		$512.86	$707.95	$1,348.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $645.65 / $1,071.52	Professional		$72.44	$645.65	$1,071.52