Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $691.83 / $7,943.28	Facility		$67.61	$691.83	$7,943.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $288.40 / $707.95 / $8,128.31	Facility	50	$288.40	$707.95	$8,128.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $70.79 / $199.53	Professional		$34.67	$70.79	$199.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $154.88 / $331.13	Professional	50	$66.07	$154.88	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $109.65	Professional		$42.66	$60.26	$109.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $138.04 / $177.83	Professional	50	$75.86	$138.04	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $467.74 / $562.34	Facility		$67.61	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $151.36	Professional		$42.66	$72.44	$151.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $63.10 / $131.83	Facility		$39.81	$63.10	$131.83
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 $39.81 / $63.10 / $114.82	Professional		$39.81	$63.10	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $32.36 / $47.86	Professional		$28.84	$32.36	$47.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $93.33 / $109.65	Facility		$69.18	$93.33	$109.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $70.79 / $74.13	Facility		$61.66	$70.79	$74.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $87.10 / $134.90	Professional		$51.29	$87.10	$134.90
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 $48.98 / $75.86 / $123.03	Professional		$48.98	$75.86	$123.03
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 $43.65 / $67.61 / $125.89	Professional		$43.65	$67.61	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $81.28	Professional		$31.62	$57.54	$81.28