Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,818.38 / $18,620.87	Facility		$891.25	$2,818.38	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Facility	50	$9,332.54	$9,332.54	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $691.83 / $2,511.89	Professional		$436.52	$691.83	$2,511.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $316.23 / $3,981.07 / $4,168.69	Professional	50	$316.23	$3,981.07	$4,168.69
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 $524.81 / $870.96 / $1,737.80	Professional		$524.81	$870.96	$1,737.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,096.48 / $2,290.87	Facility		$575.44	$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 $575.44 / $1,096.48 / $1,778.28	Professional		$575.44	$1,096.48	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $416.87	Professional		$32.36	$33.11	$416.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,202.26 / $1,288.25	Facility		$831.76	$1,202.26	$1,288.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $891.25	Facility		$870.96	$870.96	$891.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,122.02 / $1,621.81	Professional		$630.96	$1,122.02	$1,621.81
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 / $1,174.90 / $1,659.59	Professional		$831.76	$1,174.90	$1,659.59
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 $562.34 / $851.14 / $1,621.81	Professional		$562.34	$851.14	$1,621.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $758.58 / $1,288.25	Professional		$85.11	$758.58	$1,288.25