Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $3,467.37 / $7,244.36	Facility		$169.82	$3,467.37	$7,244.36
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,238.72 / $6,456.54 / $6,456.54	Facility	50	$2,238.72	$6,456.54	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $144.54 / $501.19	Professional		$67.61	$144.54	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $165.96	Professional		$138.04	$154.88	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,659.59	Facility		$1,000.00	$1,000.00	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $218.78 / $489.78	Professional		$109.65	$218.78	$489.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $218.78 / $1,905.46	Facility		$109.65	$218.78	$1,905.46
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $2,041.74 / $6,165.95 / $11,748.98	Facility	50	$2,041.74	$6,165.95	$11,748.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $758.58	Professional		$112.20	$208.93	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $281.84 / $346.74	Facility		$177.83	$281.84	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $239.88 / $446.68	Professional		$117.49	$239.88	$446.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,570.88 / $8,709.64	Facility		$3,090.30	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,677.35 / $6,918.31 / $13,182.57	Facility	50	$4,677.35	$6,918.31	$13,182.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $218.78 / $398.11	Professional		$114.82	$218.78	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,165.95 / $9,772.37	Facility		$1,698.24	$6,165.95	$9,772.37
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $173.78 / $380.19	Professional		$93.33	$173.78	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $141.25 / $245.47	Professional		$75.86	$141.25	$245.47