Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $1,288.25 / $10,232.93	Facility		$97.72	$1,288.25	$10,232.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility	50	$3,630.78	$3,630.78	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $181.97 / $977.24	Professional		$47.86	$181.97	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Professional		$41.69	$41.69	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $741.31	Facility		$446.68	$446.68	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $295.12 / $1,174.90	Professional		$83.18	$295.12	$1,174.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $457.09 / $1,148.15	Facility		$85.11	$457.09	$1,148.15
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,698.24 / $2,754.23 / $4,897.79	Facility	50	$1,698.24	$2,754.23	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $398.11 / $1,000.00	Professional		$85.11	$398.11	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $50.12	Professional		$32.36	$33.11	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $724.44 / $812.83	Facility		$426.58	$724.44	$812.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $588.84	Facility		$562.34	$562.34	$588.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $181.97 / $1,071.52	Professional		$74.13	$181.97	$1,071.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,949.84 / $3,715.35	Facility		$1,412.54	$1,949.84	$3,715.35
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,137.96 / $2,884.03 / $5,495.41	Facility	50	$2,137.96	$2,884.03	$5,495.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $331.13 / $1,000.00	Professional		$79.43	$331.13	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $2,570.40 / $4,786.30	Facility		$933.25	$2,570.40	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $371.54 / $1,023.29	Professional		$70.79	$371.54	$1,023.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $87.10 / $588.84	Professional		$45.71	$87.10	$588.84