Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $3,019.95 / $17,782.79	Facility		$302.00	$3,019.95	$17,782.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $691.83 / $2,884.03 / $10,715.19	Facility	50	$691.83	$2,884.03	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $851.14	Professional		$104.71	$186.21	$851.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.70 / $190.55 / $1,000.00	Professional	50	$53.70	$190.55	$1,000.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $128.82	Professional		$100.00	$117.49	$128.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	50	$169.82	$169.82	$169.82
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 $199.53 / $323.59 / $478.63	Professional		$199.53	$323.59	$478.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $380.19 / $4,786.30	Facility		$218.78	$380.19	$4,786.30
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 $204.17 / $346.74 / $1,513.56	Professional		$204.17	$346.74	$1,513.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $309.03 / $316.23	Facility		$263.03	$309.03	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $218.78 / $218.78	Facility		$208.93	$218.78	$218.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $363.08 / $467.74	Professional		$218.78	$363.08	$467.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,897.79 / $9,120.11	Facility		$3,715.35	$4,897.79	$9,120.11
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,495.41 / $7,413.10 / $13,803.84	Facility	50	$5,495.41	$7,413.10	$13,803.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $316.23 / $416.87	Professional		$213.80	$316.23	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $6,606.93 / $11,220.18	Facility		$1,995.26	$6,606.93	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $251.19 / $446.68	Professional		$154.88	$251.19	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $186.21 / $263.03	Professional		$138.04	$186.21	$263.03