Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $660.69 / $6,606.93	Facility		$125.89	$660.69	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility	50	$5,248.07	$5,248.07	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $208.93 / $562.34	Professional		$66.07	$208.93	$562.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $93.33 / $588.84 / $977.24	Professional	50	$93.33	$588.84	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $331.13 / $478.63	Professional		$104.71	$331.13	$478.63
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $676.08 / $676.08 / $676.08	Professional	50	$676.08	$676.08	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $199.53 / $588.84	Professional		$75.86	$199.53	$588.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $177.83 / $512.86	Facility		$95.50	$177.83	$512.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $177.83 / $512.86	Professional		$85.11	$177.83	$512.86
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 $275.42 / $407.38 / $457.09	Facility		$275.42	$407.38	$457.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $331.13	Facility		$316.23	$316.23	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $281.84 / $616.60	Professional		$104.71	$281.84	$616.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $257.04 / $524.81	Professional		$112.20	$257.04	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $660.69 / $6,165.95	Facility		$416.87	$660.69	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $208.93 / $512.86	Professional		$77.62	$208.93	$512.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $109.65 / $338.84	Professional		$57.54	$109.65	$338.84