Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $16,982.44	Facility		$954.99	$1,862.09	$16,982.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $7,943.28 / $12,882.50 / $12,882.50	Facility	50	$7,943.28	$12,882.50	$12,882.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $758.58 / $2,344.23	Professional		$467.74	$758.58	$2,344.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Professional		$912.01	$912.01	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $3,311.31	Facility		$1,995.26	$1,995.26	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,230.27 / $2,089.30	Professional		$676.08	$1,230.27	$2,089.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,288.25 / $3,801.89	Facility		$691.83	$1,288.25	$3,801.89
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,456.54 / $10,964.78 / $22,387.21	Facility	50	$6,456.54	$10,964.78	$22,387.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,258.93 / $2,187.76	Professional		$691.83	$1,258.93	$2,187.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,348.96 / $1,513.56	Facility		$954.99	$1,348.96	$1,513.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,230.27 / $1,905.46	Professional		$691.83	$1,230.27	$1,905.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,120.11 / $17,378.01	Facility		$5,888.44	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,912.51 / $13,803.84 / $26,302.68	Facility	50	$8,912.51	$13,803.84	$26,302.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,148.15 / $1,737.80	Professional		$724.44	$1,148.15	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,481.54 / $19,952.62	Facility		$1,995.26	$11,481.54	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $954.99 / $1,862.09	Professional		$616.60	$954.99	$1,862.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $758.58 / $1,071.52	Professional		$457.09	$758.58	$1,071.52