Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $4,466.84 / $18,620.87	Facility		$891.25	$4,466.84	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,606.93 / $6,606.93 / $6,760.83	Facility	50	$6,606.93	$6,606.93	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $676.08 / $1,412.54	Professional		$446.68	$676.08	$1,412.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $134.90 / $208.93 / $707.95	Professional	50	$134.90	$208.93	$707.95
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 $537.03 / $851.14 / $1,659.59	Professional		$537.03	$851.14	$1,659.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,096.48 / $2,290.87	Facility		$602.56	$1,096.48	$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 $602.56 / $1,096.48 / $1,698.24	Professional		$602.56	$1,096.48	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $398.11	Professional		$32.36	$33.11	$398.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,148.15 / $1,258.93	Facility		$831.76	$1,148.15	$1,258.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $851.14	Facility		$831.76	$831.76	$851.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,122.02 / $1,548.82	Professional		$630.96	$1,122.02	$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 $831.76 / $1,148.15 / $1,584.89	Professional		$831.76	$1,148.15	$1,584.89
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 $575.44 / $812.83 / $1,548.82	Professional		$575.44	$812.83	$1,548.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $741.31 / $1,230.27	Professional		$83.18	$741.31	$1,230.27