Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $776.25 / $11,481.54	Facility		$107.15	$776.25	$11,481.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $48.98 / $776.25 / $1,122.02	Facility	50	$48.98	$776.25	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $309.03	Professional		$54.95	$104.71	$309.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $117.49 / $302.00 / $537.03	Professional	50	$117.49	$302.00	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $77.62 / $169.82	Professional		$48.98	$77.62	$169.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $117.49 / $213.80 / $269.15	Professional	50	$117.49	$213.80	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $467.74 / $562.34	Facility		$107.15	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $112.20 / $234.42	Professional		$63.10	$112.20	$234.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $102.33 / $204.17	Facility		$63.10	$102.33	$204.17
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $676.08 / $1,174.90 / $2,137.96	Facility	50	$676.08	$1,174.90	$2,137.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $102.33 / $181.97	Professional		$63.10	$102.33	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $147.91 / $165.96	Facility		$107.15	$147.91	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $109.65 / $112.20	Facility		$100.00	$109.65	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $208.93	Professional		$81.28	$141.25	$208.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $831.76 / $1,621.81	Facility		$562.34	$831.76	$1,621.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $851.14 / $1,258.93 / $2,398.83	Facility	50	$851.14	$1,258.93	$2,398.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $186.21	Professional		$77.62	$120.23	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,071.52 / $2,454.71	Facility		$416.87	$1,071.52	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $194.98	Professional		$69.18	$102.33	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $89.13 / $125.89	Professional		$48.98	$89.13	$125.89