Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $5,248.07 / $9,120.11	Facility		$794.33	$5,248.07	$9,120.11
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,709.64 / $12,882.50 / $15,135.61	Facility	50	$8,709.64	$12,882.50	$15,135.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $446.68 / $2,570.40	Professional		$141.25	$446.68	$2,570.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $1,047.13	Professional		$218.78	$288.40	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $489.78 / $1,479.11	Professional		$239.88	$489.78	$1,479.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $954.99 / $1,905.46	Facility		$245.47	$954.99	$1,905.46
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $2,570.40 / $6,165.95 / $11,748.98	Facility	50	$2,570.40	$6,165.95	$11,748.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $812.83 / $1,548.82	Professional		$257.04	$812.83	$1,548.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $954.99 / $1,288.25	Facility		$794.33	$954.99	$1,288.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $707.95	Facility		$676.08	$676.08	$707.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $537.03 / $1,318.26	Professional		$213.80	$537.03	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,570.88 / $8,709.64	Facility		$3,090.30	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,677.35 / $6,918.31 / $13,182.57	Facility	50	$4,677.35	$6,918.31	$13,182.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $602.56 / $1,258.93	Professional		$229.09	$602.56	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,165.95 / $9,772.37	Facility		$1,698.24	$6,165.95	$9,772.37
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $524.81 / $1,412.54	Professional		$208.93	$524.81	$1,412.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $245.47 / $691.83	Professional		$128.82	$245.47	$691.83