Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $1,513.56 / $13,803.84	Facility		$295.12	$1,513.56	$13,803.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,467.37 / $8,317.64 / $15,848.93	Facility	50	$3,467.37	$8,317.64	$15,848.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $371.54 / $1,412.54	Professional		$186.21	$371.54	$1,412.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $87.10 / $616.60 / $2,511.89	Professional	50	$87.10	$616.60	$2,511.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $173.78 / $602.56	Professional		$158.49	$173.78	$602.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $234.42 / $457.09	Professional	50	$169.82	$234.42	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $3,311.31	Facility		$1,995.26	$1,995.26	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $489.78 / $851.14	Professional		$275.42	$489.78	$851.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $575.44 / $3,890.45	Facility		$295.12	$575.44	$3,890.45
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,456.54 / $10,964.78 / $22,387.21	Facility	50	$6,456.54	$10,964.78	$22,387.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $537.03 / $1,737.80	Professional		$295.12	$537.03	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $79.43	Professional		$32.36	$33.11	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $575.44 / $831.76	Facility		$489.78	$575.44	$831.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $407.38 / $407.38	Facility		$398.11	$407.38	$407.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $446.68 / $758.58	Professional		$251.19	$446.68	$758.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $9,120.11 / $17,378.01	Facility		$5,888.44	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,912.51 / $13,803.84 / $26,302.68	Facility	50	$8,912.51	$13,803.84	$26,302.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $741.31	Professional		$288.40	$457.09	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,481.54 / $19,952.62	Facility		$1,995.26	$11,481.54	$19,952.62
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $446.68 / $776.25	Professional		$234.42	$446.68	$776.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $288.40 / $426.58	Professional		$154.88	$288.40	$426.58