Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $3,162.28 / $11,481.54	Facility		$338.84	$3,162.28	$11,481.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,677.35 / $8,709.64 / $9,332.54	Facility	50	$4,677.35	$8,709.64	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $309.03 / $1,096.48	Professional		$162.18	$309.03	$1,096.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $407.38 / $645.65 / $1,819.70	Professional	50	$407.38	$645.65	$1,819.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $446.68 / $676.08	Professional		$354.81	$446.68	$676.08
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $371.54 / $645.65 / $794.33	Professional	50	$371.54	$645.65	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,862.09	Facility		$1,122.02	$1,122.02	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $436.52 / $724.44	Professional		$257.04	$436.52	$724.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $457.09 / $2,187.76	Facility		$245.47	$457.09	$2,187.76
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $4,365.16 / $6,456.54 / $12,589.25	Facility	50	$4,365.16	$6,456.54	$12,589.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $436.52 / $912.01	Professional		$245.47	$436.52	$912.01
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 $354.81 / $489.78 / $524.81	Facility		$354.81	$489.78	$524.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $354.81 / $354.81	Facility		$346.74	$354.81	$354.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $398.11 / $660.69	Professional		$223.87	$398.11	$660.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $4,786.30 / $9,120.11	Facility		$3,548.13	$4,786.30	$9,120.11
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,248.07 / $7,244.36 / $13,803.84	Facility	50	$5,248.07	$7,244.36	$13,803.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $371.54 / $602.56	Professional		$245.47	$371.54	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,606.93 / $10,715.19	Facility		$1,698.24	$6,606.93	$10,715.19
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $354.81 / $660.69	Professional		$208.93	$354.81	$660.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $263.03 / $389.05	Professional		$138.04	$263.03	$389.05