Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $1,737.80 / $10,232.93	Facility		$97.72	$1,737.80	$10,232.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,230.27 / $1,230.27 / $2,089.30	Facility	50	$1,230.27	$1,230.27	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $109.65 / $331.13	Professional		$51.29	$109.65	$331.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $263.03 / $676.08	Professional	50	$112.20	$263.03	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $204.17	Professional		$100.00	$154.88	$204.17
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	50	$125.89	$125.89	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $707.95 / $870.96	Facility		$120.23	$707.95	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $109.65 / $251.19	Professional		$63.10	$109.65	$251.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $104.71 / $223.87	Facility		$58.88	$104.71	$223.87
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $776.25 / $2,570.40 / $5,011.87	Facility	50	$776.25	$2,570.40	$5,011.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $102.33 / $194.98	Professional		$58.88	$102.33	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $58.88	Professional		$32.36	$33.11	$58.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $162.18 / $181.97	Facility		$109.65	$162.18	$181.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $120.23 / $123.03	Facility		$114.82	$120.23	$123.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $128.82 / $223.87	Professional		$74.13	$128.82	$223.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,949.84 / $3,715.35	Facility		$1,318.26	$1,949.84	$3,715.35
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,995.26 / $2,951.21 / $5,623.41	Facility	50	$1,995.26	$2,951.21	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $204.17	Professional		$70.79	$123.03	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,454.71 / $4,786.30	Facility		$891.25	$2,454.71	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $107.15 / $199.53	Professional		$63.10	$107.15	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $85.11 / $134.90	Professional		$44.67	$85.11	$134.90