Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $2,754.23 / $9,549.93	Facility		$199.53	$2,754.23	$9,549.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,786.30 / $7,244.36 / $9,332.54	Facility	50	$4,786.30	$7,244.36	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $524.81 / $1,995.26	Professional		$100.00	$524.81	$1,995.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $512.86 / $3,019.95 / $4,466.84	Professional	50	$512.86	$3,019.95	$4,466.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $2,290.87	Facility		$1,380.38	$1,380.38	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $467.74 / $1,659.59	Professional		$158.49	$467.74	$1,659.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $776.25 / $2,238.72	Facility		$154.88	$776.25	$2,238.72
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,905.46 / $5,495.41 / $14,454.40	Facility	50	$1,905.46	$5,495.41	$14,454.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $616.60 / $1,659.59	Professional		$158.49	$616.60	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $61.66	Professional		$32.36	$33.11	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,071.52 / $1,174.90	Facility		$660.69	$1,071.52	$1,174.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $831.76 / $851.14	Facility		$812.83	$831.76	$851.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $346.74 / $1,548.82	Professional		$138.04	$346.74	$1,548.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $5,754.40 / $10,964.78	Facility		$3,801.89	$5,754.40	$10,964.78
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,754.40 / $8,709.64 / $16,595.87	Facility	50	$5,754.40	$8,709.64	$16,595.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $707.95 / $1,445.44	Professional		$147.91	$707.95	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $7,244.36 / $12,589.25	Facility		$933.25	$7,244.36	$12,589.25
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $489.78 / $1,479.11	Professional		$131.83	$489.78	$1,479.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $165.96 / $831.76	Professional		$89.13	$165.96	$831.76