Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $1,000.00 / $7,943.28	Facility		$112.20	$1,000.00	$7,943.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $660.69 / $707.95 / $1,122.02	Facility	50	$660.69	$707.95	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $112.20 / $331.13	Professional		$57.54	$112.20	$331.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $275.42 / $831.76	Professional	50	$54.95	$275.42	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $467.74 / $562.34	Facility		$186.21	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $134.90 / $302.00	Professional		$67.61	$134.90	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $144.54 / $288.40	Facility		$81.28	$144.54	$288.40
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $676.08 / $1,174.90 / $2,137.96	Facility	50	$676.08	$1,174.90	$2,137.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $275.42	Professional		$81.28	$141.25	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $60.26	Professional		$32.36	$33.11	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $218.78 / $239.88	Facility		$162.18	$218.78	$239.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $154.88 / $281.84	Professional		$74.13	$154.88	$281.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $831.76 / $1,621.81	Facility		$562.34	$831.76	$1,621.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $851.14 / $1,258.93 / $2,398.83	Facility	50	$851.14	$1,258.93	$2,398.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $138.04 / $263.03	Professional		$69.18	$138.04	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,071.52 / $2,454.71	Facility		$416.87	$1,071.52	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $128.82 / $257.04	Professional		$66.07	$128.82	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $89.13 / $177.83	Professional		$46.77	$89.13	$177.83