Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $1,737.80 / $17,782.79	Facility		$123.03	$1,737.80	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $177.83 / $616.60	Professional		$63.10	$177.83	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $194.98 / $758.58	Professional		$75.86	$194.98	$758.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $194.98 / $831.76	Facility		$93.33	$194.98	$831.76
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 $81.28 / $162.18 / $707.95	Professional		$81.28	$162.18	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $63.10	Professional		$32.36	$33.11	$63.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $512.86 / $645.65	Facility		$263.03	$512.86	$645.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $457.09	Facility		$436.52	$436.52	$457.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $263.03 / $812.83	Professional		$102.33	$263.03	$812.83
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 $104.71 / $245.47 / $691.83	Professional		$104.71	$245.47	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,570.40 / $4,786.30	Facility		$891.25	$2,570.40	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $199.53 / $616.60	Professional		$75.86	$199.53	$616.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $112.20 / $457.09	Professional		$60.26	$112.20	$457.09