Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $1,000.00 / $6,606.93	Facility		$70.79	$1,000.00	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,862.09 / $2,187.76 / $6,918.31	Facility	50	$1,862.09	$2,187.76	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $64.57 / $190.55	Professional		$30.20	$64.57	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $42.66 / $54.95	Professional		$13.80	$42.66	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $79.43 / $218.78	Professional		$38.90	$79.43	$218.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $79.43 / $389.05	Facility		$44.67	$79.43	$389.05
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $630.96 / $1,659.59 / $3,090.30	Facility	50	$630.96	$1,659.59	$3,090.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $74.13 / $199.53	Professional		$40.74	$74.13	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $32.36 / $53.70	Professional		$19.95	$32.36	$53.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $151.36 / $165.96	Facility		$66.07	$151.36	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $107.15 / $213.80	Professional		$50.12	$107.15	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,174.90 / $2,238.72	Facility		$812.83	$1,174.90	$2,238.72
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $676.08 / $676.08 / $851.14	Facility	50	$676.08	$676.08	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $87.10 / $186.21	Professional		$51.29	$87.10	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,479.11 / $3,162.28	Facility		$549.54	$1,479.11	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $81.28 / $199.53	Professional		$38.02	$81.28	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $52.48 / $120.23	Professional		$27.54	$52.48	$120.23