Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,513.56 / $17,782.79	Facility		$776.25	$1,513.56	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $602.56 / $1,380.38	Professional		$407.38	$602.56	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $3,801.89	Facility		$645.65	$645.65	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $758.58 / $1,445.44	Professional		$467.74	$758.58	$1,445.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,000.00 / $3,630.78	Facility		$524.81	$1,000.00	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $977.24 / $2,089.30	Professional		$524.81	$977.24	$2,089.30
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 $724.44 / $1,000.00 / $1,096.48	Facility		$724.44	$1,000.00	$1,096.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $741.31 / $933.25	Facility		$724.44	$741.31	$933.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,000.00 / $1,348.96	Professional		$575.44	$1,000.00	$1,348.96
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 Professional Modifier Low / Median / High Price $741.31 / $1,000.00 / $1,380.38	Professional		$741.31	$1,000.00	$1,380.38
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 $489.78 / $724.44 / $1,348.96	Professional		$489.78	$724.44	$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