Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $2,187.76 / $7,943.28	Facility		$223.87	$2,187.76	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $269.15 / $1,318.26	Professional		$97.72	$269.15	$1,318.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $645.65	Professional		$141.25	$186.21	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $346.74 / $912.01	Professional		$173.78	$346.74	$912.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $501.19 / $1,513.56	Facility		$173.78	$501.19	$1,513.56
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,513.56 / $2,630.27 / $4,570.88	Facility	50	$1,513.56	$2,630.27	$4,570.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $416.87 / $891.25	Professional		$177.83	$416.87	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $67.61	Professional		$32.36	$33.11	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $588.84 / $630.96	Facility		$398.11	$588.84	$630.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $436.52	Facility		$426.58	$426.58	$436.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $380.19 / $831.76	Professional		$151.36	$380.19	$831.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,778.28 / $3,388.44	Facility		$1,202.26	$1,778.28	$3,388.44
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,819.70 / $2,691.53 / $5,128.61	Facility	50	$1,819.70	$2,691.53	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $354.81 / $776.25	Professional		$173.78	$354.81	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $2,344.23 / $4,570.88	Facility		$933.25	$2,344.23	$4,570.88
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $323.59 / $912.01	Professional		$147.91	$323.59	$912.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $177.83 / $457.09	Professional		$93.33	$177.83	$457.09