Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $5,128.61 / $18,620.87	Facility		$588.84	$5,128.61	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,754.40 / $5,754.40 / $7,079.46	Facility	50	$5,754.40	$5,754.40	$7,079.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $575.44 / $1,380.38	Professional		$295.12	$575.44	$1,380.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $245.47 / $575.44 / $2,137.96	Professional	50	$245.47	$575.44	$2,137.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $426.58 / $645.65	Professional		$75.86	$426.58	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $776.25 / $1,258.93	Professional		$489.78	$776.25	$1,258.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $912.01 / $12,022.64	Facility		$524.81	$912.01	$12,022.64
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $12,022.64 / $13,803.84 / $23,442.29	Facility	50	$12,022.64	$13,803.84	$23,442.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $851.14 / $1,412.54	Professional		$478.63	$851.14	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $831.76 / $1,258.93	Facility		$676.08	$831.76	$1,258.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $588.84	Facility		$575.44	$575.44	$588.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $660.69 / $1,047.13	Professional		$363.08	$660.69	$1,047.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $9,120.11 / $17,378.01	Facility		$6,165.95	$9,120.11	$17,378.01
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $9,332.54 / $13,489.63 / $25,703.96	Facility	50	$9,332.54	$13,489.63	$25,703.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $676.08 / $1,000.00	Professional		$371.54	$676.08	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $11,748.98 / $19,054.61	Facility		$3,311.31	$11,748.98	$19,054.61
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $630.96 / $1,096.48	Professional		$371.54	$630.96	$1,096.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $457.09 / $794.33	Professional		$275.42	$457.09	$794.33