Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $7,943.28 / $20,892.96	Facility		$1,230.27	$7,943.28	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $758.58 / $1,905.46	Professional		$602.56	$758.58	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,000.00 / $1,995.26	Professional		$602.56	$1,000.00	$1,995.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,621.81 / $9,549.93	Facility		$794.33	$1,621.81	$9,549.93
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $9,549.93 / $15,488.17 / $27,542.29	Facility	50	$9,549.93	$15,488.17	$27,542.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,548.82 / $3,090.30	Professional		$794.33	$1,548.82	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $371.54	Professional		$32.36	$33.11	$371.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,230.27 / $1,288.25	Facility		$912.01	$1,230.27	$1,288.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $870.96	Facility		$851.14	$851.14	$870.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,445.44 / $1,862.09	Professional		$870.96	$1,445.44	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $10,964.78 / $20,892.96	Facility		$7,244.36	$10,964.78	$20,892.96
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,964.78 / $16,595.87 / $31,622.78	Facility	50	$10,964.78	$16,595.87	$31,622.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,318.26 / $2,041.74	Professional		$851.14	$1,318.26	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $12,022.64 / $22,387.21	Facility		$1,698.24	$12,022.64	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $954.99 / $1,778.28	Professional		$660.69	$954.99	$1,778.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $758.58 / $1,071.52	Professional		$85.11	$758.58	$1,071.52