Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $53.70 / $446.68	Facility		$31.62	$53.70	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $30.90 / $70.79	Professional		$16.98	$30.90	$70.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $67.61 / $102.33	Professional	50	$47.86	$67.61	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $27.54 / $33.88	Professional		$24.55	$27.54	$33.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $36.31 / $51.29	Professional	50	$36.31	$36.31	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Facility		$33.11	$33.11	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $36.31 / $77.62	Professional		$17.78	$36.31	$77.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $39.81 / $72.44	Facility		$24.55	$39.81	$72.44
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $281.84 / $630.96 / $1,148.15	Facility	50	$281.84	$630.96	$1,148.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.90 / $66.07	Professional		$24.55	$38.90	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $32.36 / $33.11	Professional		$14.79	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $56.23 / $67.61	Facility		$42.66	$56.23	$67.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $37.15 / $38.02	Facility		$29.51	$37.15	$38.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.66 / $70.79	Professional		$24.55	$42.66	$70.79
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 Facility Modifier 50 Low / Median / High Price $457.09 / $676.08 / $1,288.25	Facility	50	$457.09	$676.08	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $38.02 / $63.10	Professional		$23.99	$38.02	$63.10
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 $22.39 / $39.81 / $70.79	Professional		$22.39	$39.81	$70.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $54.95	Professional		$28.84	$33.11	$54.95