Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $660.69 / $6,456.54	Facility		$69.18	$660.69	$6,456.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $776.25 / $1,202.26 / $7,244.36	Facility	50	$776.25	$1,202.26	$7,244.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $74.13 / $257.04	Professional		$38.90	$74.13	$257.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $151.36 / $407.38	Professional	50	$79.43	$151.36	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $70.79 / $114.82	Professional		$51.29	$70.79	$114.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $83.18 / $97.72 / $128.82	Professional	50	$83.18	$97.72	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $467.74 / $562.34	Facility		$81.28	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $74.13 / $154.88	Professional		$44.67	$74.13	$154.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $77.62 / $138.04	Facility		$45.71	$77.62	$138.04
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 $45.71 / $75.86 / $128.82	Professional		$45.71	$75.86	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $32.36 / $48.98	Professional		$28.84	$32.36	$48.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $100.00 / $112.20	Facility		$69.18	$100.00	$112.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $74.13 / $75.86	Facility		$64.57	$74.13	$75.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $91.20 / $138.04	Professional		$52.48	$91.20	$138.04
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 $50.12 / $79.43 / $125.89	Professional		$50.12	$79.43	$125.89
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 $45.71 / $70.79 / $128.82	Professional		$45.71	$70.79	$128.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $83.18	Professional		$32.36	$58.88	$83.18