Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $363.08 / $794.33	Facility		$70.79	$363.08	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $91.20 / $251.19	Professional		$50.12	$91.20	$251.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $181.97 / $323.59	Professional	50	$181.97	$181.97	$323.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $114.82 / $138.04	Professional		$61.66	$114.82	$138.04
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $104.71 / $104.71 / $104.71	Professional	50	$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.33 / $208.93	Professional		$57.54	$102.33	$208.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $100.00 / $181.97	Facility		$58.88	$100.00	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $100.00 / $165.96	Professional		$58.88	$100.00	$165.96
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 $100.00 / $138.04 / $147.91	Facility		$100.00	$138.04	$147.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $100.00	Facility		$93.33	$93.33	$100.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $186.21	Professional		$70.79	$123.03	$186.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $851.14	Facility		$302.00	$446.68	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $104.71 / $165.96	Professional		$66.07	$104.71	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $616.60 / $1,513.56	Facility		$416.87	$616.60	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $173.78	Professional		$60.26	$91.20	$173.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $120.23	Professional		$50.12	$85.11	$120.23